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could this kid have acid reflux?
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<blockquote data-quote="confuzzled" data-source="post: 387239" data-attributes="member: 8831"><p>is there a gastroenterologist on board? (i'm guessing not)</p><p> </p><p>thats who would do an endoscope, and thats who would look at reflux and other (more rare) esophageal anomolies...including hiatal hernias, strictures, even eosinophilic esophogitis, just to name a few.</p><p> </p><p>personally, i'd want a gastroenterologist on board anyway--she really needs to be hooked into a gi clinic with a nutrition department. calories arent everything, nor is weight gain. you havent posted your hospital shake recipe, but unless its VERY complete i have a hard time believing that with her limited intake she could be nutritionally stable. certainly, someone can live on a blended (liquified) diet, but it needs to be carefully monitored for vitamins/minerals and other balanced nutrients. and there are very good commerical "complete" liquid diets available--easy otc ones are ensure plus and boost, but even they may need to be additionally supplemented...zinc comes to mind, sometimes iron if an iron based formula cant be tolerated (can cause constipation). those two are milk based products, but there are hypoallergenic products available if a milk intolerance is suspected. there is even a juice that is nutritionally complete-who's name escapes me (its something like EO27, but i can't say for sure). at this point, even a low sodium V-8 has more nutritional value than a mcD's shake, if you could get her to drink it...you mentioned tomato soup, so maybe even heat it and say its soup.</p><p> </p><p>but this is really becoming unmanagable without proper medical guidance. and its going on way too long...its horrible when you have to piece together services, but at this point nutritional needs have far surpassed psychiatric ones--i am very surprised at the lacksidasial attitude of your current team, and i'm really shocked they havent, at the very <em>least</em>, inserted an NG tube, which could be easily managed at home.</p><p> </p><p>honestly, this is way beyond a pediatrician. i know you dont want to hear that, but it is. no matter what direction this goes in, medical or psychiatric, specialists need to be on board. i'm under the impression you were hooked up with an eating specialist (pediatrician's next door neighbor?)...ruling out medical causes is the "first do no harm" course of treatment, <em>before</em> theraputic ones. </p><p> </p><p> </p><p>its their job to be ruling out every single known to man medical cause, and it shouldnt be your responsibility to direct them. (gi's foam at the mouth over endoscopes--routine, easy procedures for them-and beats going in the other direction...thats not <em>quite</em> as fun.)</p><p> </p><p>in today's litigious society, the <em>last</em> thing doctors think about are "unneccessary" tests...no test is "unnecessary" if you miss something and get your pants sued off.</p><p> </p><p>seriously.</p></blockquote><p></p>
[QUOTE="confuzzled, post: 387239, member: 8831"] is there a gastroenterologist on board? (i'm guessing not) thats who would do an endoscope, and thats who would look at reflux and other (more rare) esophageal anomolies...including hiatal hernias, strictures, even eosinophilic esophogitis, just to name a few. personally, i'd want a gastroenterologist on board anyway--she really needs to be hooked into a gi clinic with a nutrition department. calories arent everything, nor is weight gain. you havent posted your hospital shake recipe, but unless its VERY complete i have a hard time believing that with her limited intake she could be nutritionally stable. certainly, someone can live on a blended (liquified) diet, but it needs to be carefully monitored for vitamins/minerals and other balanced nutrients. and there are very good commerical "complete" liquid diets available--easy otc ones are ensure plus and boost, but even they may need to be additionally supplemented...zinc comes to mind, sometimes iron if an iron based formula cant be tolerated (can cause constipation). those two are milk based products, but there are hypoallergenic products available if a milk intolerance is suspected. there is even a juice that is nutritionally complete-who's name escapes me (its something like EO27, but i can't say for sure). at this point, even a low sodium V-8 has more nutritional value than a mcD's shake, if you could get her to drink it...you mentioned tomato soup, so maybe even heat it and say its soup. but this is really becoming unmanagable without proper medical guidance. and its going on way too long...its horrible when you have to piece together services, but at this point nutritional needs have far surpassed psychiatric ones--i am very surprised at the lacksidasial attitude of your current team, and i'm really shocked they havent, at the very [I]least[/I], inserted an NG tube, which could be easily managed at home. honestly, this is way beyond a pediatrician. i know you dont want to hear that, but it is. no matter what direction this goes in, medical or psychiatric, specialists need to be on board. i'm under the impression you were hooked up with an eating specialist (pediatrician's next door neighbor?)...ruling out medical causes is the "first do no harm" course of treatment, [I]before[/I] theraputic ones. its their job to be ruling out every single known to man medical cause, and it shouldnt be your responsibility to direct them. (gi's foam at the mouth over endoscopes--routine, easy procedures for them-and beats going in the other direction...thats not [I]quite[/I] as fun.) in today's litigious society, the [I]last[/I] thing doctors think about are "unneccessary" tests...no test is "unnecessary" if you miss something and get your pants sued off. seriously. [/QUOTE]
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could this kid have acid reflux?
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