Wednesday, March 16, 2011

Gastro update

3/15/11 School Report - Speech: Greetings, association puzzles, where/what ?'s with pictures. Finding teacher pictures [good], no no no teacher names.

I'm still a tad behind on the blog. On Monday (yesterday) I took Nikko to see Dr. Nelson. It has been one month since the last visit. I told her that we've been on the mineral oil only a week so I'm waiting to see a pattern. He had only pee diapers but a poop smear at day's end for three days, and then the poop smears got more solid and increased inconsistently over the weekend. We are down to about four poop smears a day. The doc said that since we weren't at goal yet, we could increase the dosage by a half tablespoon and see what happens. Goal is 1-2 BMs of considerable volume. I had some questions to ask her as well:

Could she remind me what the health concerns were regarding mineral oil? - If ingested incorrectly, like while laying down at night, the oil could get into his lungs. Bad problem.

Can Nikko use probiotics? - Her answer was she doesn't recommend it, but it doesn't bother her either. She said that probiotics aren't really proven to help most kids. She didn't see a difference whether or not a kid used them. NOTE: A tiny red flag waved in the back of my brain. If she doesn't recommend them, then why on my last visit, where we waited half an hour because they were running late so I got bored and rummaged through a cabinet, did I see boxes of Align, a probiotic? If she is a gastro (read: gut) doctor, wouldn't something like probiotics be right up her alley?

What is the plan, once he settles into a regular BM pattern on mineral oil? - Then we stay the course for a couple of months, then wean him off of it while adding fiber back into his diet.

What is the plan if it doesn't work? What is the next thing to try? - She said we would probably tweak his dosage until it worked. I asked if there was something beyond mineral oil and she looked at me saying, "Well, those are the three medicines I use in this practice." I don't think I got as complete an answer I was looking for, but maybe tweaking the dosage was her answer and that's all I got.

In a week I will call her with Nikko's progress, so for now I'll up the dosage and see what happens. I have mixed feelings about mineral oil, but currently I can see that *something* is happening. Nikko's BMs are becoming slightly more formed, sometimes fibrous depending on what he ate, sometimes peanut buttery, but never like a rock. And we have gone down from 10+ smears a day to 3-4 poop smears of varying volume a day. That's progress in a sense. What I wish I didn't have to do is pour 1 1/2 tablespoons of oil into Nikko's juice every morning. My comfort is that the juice is really good-tasting apple juice, and mineral oil is odorless and tasteless. I hope he really doesn't notice the oil floating around in his sippy cup. And yes, I have to give it to him in a sippy because it's enclosed and he can drink from a straw. Giving him meds in an open cup means he can see what's floating around and will most likely reject the drink.

The one thing I'm happy to report is that there are little to no more room-clearing bouts of gassiness.

No comments:

Post a Comment