This is a picture of Taylor before her procedure yesterday. She LOVES doctors and nurses and hospitals. I really have NO idea where she gets that from because hospitals used to cause me to have panic attacks. Literally. And, after a recent trip to our pediatrician, Taylor declared she wants to be a doctor when she grows up. (I guess we better start that college fund).
Taylor was born at 37wks after a very quick and intense labor for Mommy. From the very start, she spit up often. I had been surounded by babies and children for as long as I remember so I know babies spit up. But, by 3wks I was saying "This isn't normal!". She would projectile vomit (like a foot away), 15-20x/day. At the time, I didn't know my breastfed baby was allergic to dairy (which I was consuming daily), but I knew something was wrong. It took 3 months for our pediatrician to take us seriously. She ordered an upper GI, which involved feeding Taylor a bottle of barium, while we watched her gastrointestinal tract on a monitor. It showed her refluxing several times as she squirmed and screamed (exactly like she did when we nursed). I finally had a better understanding of why my baby was so miserable.
To make a very long story short, Taylor was diagnosed with GERD: Gastro-esophageal reflux disease after that test. As an adult, you know it as heartburn. Heartburn becomes a "disease" when it's frequent and chronic, and uncomfortable (I'm sure there's more specific diagnostic criteria, but that's the layman's terms version ;) ). Taylor has daily issues with reflux. One in 3 babies is diagnosed with GERD. And the vast majority of them outgrow it by 12 months, as their GI tract matures. Taylor is now 4 and still complains of a lot of tummy pain and has daily reflux symptoms. Since she was diagnosed with asthma, her reflux symptoms have become a little more confusing. She coughs during and after meals and drinks. She's also had pneumonia twice in the last year. She also gets monthly upper-respiratory infections and has missed a lot of days of preschool because for her, a cold is almost never "just a cold". A cold, for her, means a fever, a trip to the pediatrician, sometimes a chest x-ray to rule out pneumonia, antibiotics and several missed days of preschool.
So, all of this brings us to how we've spent Monday and Tuesday. Our GI decided some more tests were necessary at our follow up appt about a month ago. He wants to ensure she gets on appropriate medications, that there isn't more going on with her than we think and he's thinking maybe she actually has "non-acidic" reflux. So, he did an endoscopy and an impedence probe (the tube that you see in the first picture) to measure the acidic and non-acidic reflux that she may be having. The scope involves a tiny tube with a camera attached to it going into her esphogeous and looking into her stomach.
The impedence probe is a tiny probe that goes through her nose (as pictured above), into her esophagus and it sits just above the opening of her stomach. It measure the acid in her reflux, how far it goes up into her esophagous and how often she refluxes. The probe is attached to a recording device. So, our GI gave Taylor a sedative (what they call conscious sedation) to make her sleep during the procedure. He then did the scope and inserted the probe that would remain inside her for the next 24 hrs. The procedure itself is only about 15 minutes.
This is a picture of her shortly after the procedure. When she first came back to us she was awake and delirious, and not very happy. She was also quite chatty. She really needed to sleep so the drugs could wear off. Her face is red and puffy in the picture because she seemed to be having an allergic reaction to the drugs she was given. Fortunately, we were very quick in catching it and it resolved with Benadryl that the doctor ordered. The picture below was taken about 20 minutes after the Benadryl was administered via IV. They wrapped a bandage around her IV port prior to the procedure because she didn't want to have to see it. :)
When I explained to her that she was going to the hospital and what would be done, I told her she could bring a blanket and a stuffed animal or doll. When I asked what blanket she wanted to bring, she said "My sweater blanket". Our wonderful nurse was quite impressed when she commented on how cozy the blanket was and Taylor responded "My mommy made it for me!".
The Benadryl helped Taylor settle back down after the procedure and she slept for another hour and a half. We were sent home with the probe in, the recording device, and a form to write down every time she ate, slept, and had reflux symptoms. They'll then, review the recording on the monitor and compare it to what we had written down to determine the severity of her reflux and what the best treatment is.
While we were at home, Taylor wore her backpack with her monitor inside. We were really worried she would pull the tube out but she did really well with it. She said it was bugging her nose a few times, and when I questioned her about it she said she could feel it in her nose and in her throat. Here's a pic of the monitor/recording device.
We went back to the hospital on Tuesday to have the probe removed (very simple, literally just pulled it out. Painless, except for pulling the tape off), and Taylor was quite excited to see her nurse again, who tended to us yesterday. She colored a picture especially for her and ran and gave her a huge hug when she saw her! I actually almost got teary eyed because I work with so many nurses, I have a very special place in my heart for them. Our nurse thought Taylor was pretty special, too. When she greeted us yesterday, Taylor was her typical energetic self and the nurse said "Wow, this is great I love enthusiastic patients!" My response? "Well, then you're the perfect nurse for us because she's definitely enthusiastic!"
We should get the results of the probe in about a week. The scope looked good on first glance, just mild esophagitis that was there the last time we had this done 2 yrs ago. The GI took biopsies to test the tissue and rule out other conditions for her symptoms. We also need to schedule a swallow study to help determine why she's coughing and gagging when she eats.
Thanks for reading this far. :) If any of you have questions about reflux, please ask me and I'll answer you the best that I can. If you want more information on reflux and are also managing food allergies, there is a wonderful forum/message board to discuss food allergies, reflux, asthma and eczema at www.kidswithfoodallergies.org. You can also visit infantreflux.org and reflux.org.