For those of you that don't know, Jamie had gastric reflux as a baby. This meant that he spit up (read: projectile vomited) almost constantly, requiring clothing changes so often I lost count for both me and him. Liam had it, too, to a much lesser extent, so when Jamie started showing signs of it while we were still in the hospital immediately after birth my Mom-dar sat up and started whooping.
Turns out I was right and we went through what I commonly refer to as "hell" getting it under control. There was never a magic bullet for Jamie like there was for Liam and so the best we could hope for was "oh God, let me get some sleep." We eventually got it narrowed down to Prevacid being the best bet and waiting out the colic that we were also gifted with.
Once we got through the colic, things calmed down a lot and he settled into the Prevacid routine. It's been that way from the time he was around 4 months old. His dosage has never changed - mostly because it was so high that they couldn't even as he gained weight - and he's been stable on it for all of that time. The majority of children with reflux as infants outgrow it somewhere between 15 and 18 months. So, at his last check up I talked with our pediatrician about weaning him off his meds altogether. I'd cut his dose in half to see how he would handle it and he seemed to do quite well on the reduced dose. I got the OK to give him that dose every other day for a week and then go off completely.
I commenced with this and things were going swimmingly. A little over a week ago we stopped giving him the Prevacid.
You can see where this is going can't you?
A few days later he developed a cough in his sleep. Nothing consistent but enough to give him trouble staying asleep sometimes. I thought he'd picked up another cold at daycare but he wasn't showing any other symptoms.
Then he started having appetite issues. The kid who eats more than his 5 year old brother was not finishing meals. I thought the boulder in his mouth signaling a burgeoning molar was the culprit. Too much teething pain and he didn't want to eat.
He stopped sleeping as soundly as usual and was getting up earlier. I just thought it was a phase. Liam was such a crappy sleeper for such a long time that Jamie's fluctuations in sleep pattern have nothing on what Liam was like. Jamie on bad day isn't even as bad as Liam was on a good day.
It all came to a head a few nights ago when Scot and I spent over two hours awake with Jamie in the middle of the night. He was screaming, inconsolable, and thrashing around for all he was worth. When a nearly 30 lb toddler decides to start throwing his weight around you might as well put on a full set of hockey pads because you will get hurt otherwise.
We tried everything we could think of on the idea that he was in pain from the molar he's working on. He's never been like this when teething but his behavior all said "I am in pain and pissed off about it." He seemed to only be slightly placated if I was holding him and pacing. I was standing there in our bedroom and I thought to myself, "Damn. This is like when he was a newborn."
That was when the light bulb went off.
I turned to Scot and said "What if it's reflux? He's off meds now." The light bulb went off for him, too.
We did the best we could for him to make him comfortable with the liberal application of Mylanta and restarted him on Prevacid the next morning. Luckily, I still have about a week's worth of doses on hand. On the less fortunate side of the equation, I tried to start him on the lower dose thinking that he had been fine on it before. Well, he's not fine on it now. We've spent a miserable few days with the kid trying to get everything back under control.
I understand his pain. During both of my pregnancies I had the worst kind of heartburn imaginable. The bigger I got and the more the baby inside smushed all my organs the worse the heartburn became. At some point in both pregnancies it got so bad that my ears burned. Yes, you read that right. I would have acid come up my esophagus and then set my eustation tubes afire. If Jamie is feeling anything like that, I understand how absolutely miserable it is. Unfortunately he just doesn't understand the concept of waiting for the meds to hit full efficacy. All he knows is that he's uncomfortable and I haven't fixed it yet.
We have a doctor's appointment on Tuesday for a recheck from his last ear infection so I'll talk to the pediatrician then about getting him back on the Prevacid full time. In the meantime we'll soldier on with what we've got.
This is one of those times that I feel like an idiot as a parent, though. Generally my Mom-dar serves me pretty well. But in this case, Jamie had to be in a fair amount of pain before I connected the dots. You would think that after all we've been through with two kids that had reflux, I would recognize the signs of a problem before we had a toddler who was throwing his weight around like a member of the WWE.
Way to go, Bonehead.
Don't beat yourself up too badly. As you said, he was doing just fine — right up until he wasn't.
ReplyDeleteJust out of curiosity, can children with reflux have h. pylori? I only ask because my father, who suffered from years of heartburn, developed a cough. The cough lasted a year (maybe longer), and when he finally had it checked out, it turned out he had h. pylori — a bacterial infection of the stomach. Some strong antibiotics later, he's cured for all intents and purposes.
But I don't know if kids get something like that.
Good luck, and I'm sorry to hear about your family's reflux. I had heartburn with Gabriel, and it totally sucked. I didn't know what was wrong at first — I had never had heartburn before. My girls were champion spitter uppers, but it didn't even faze them, so I knew it wasn't reflux. I just had to change a lot of onesies and shirts!
You know, I never considered that, RPM. I looked it up and his symptoms more closely fit with GERD. Also, we had some testing done at Children's when Jamie was about 9 wks old - one of which was a nuclear medicine test where they fed him milk with a radioactive tracer in it and then scan him continuously while he digests. We actually saw him reflux right on the screen.
ReplyDeleteThe cough he gets with the GERD is only at night when he's laying flat for hours and it comes because the acid comes up and burns the esophagus/throat and makes him cough as a result. Oftentimes infant with GERD have that sort of snorky nasal congestion, too, but no real snot to speak of - again, a result of the inflammation of the mucus membranes.
Certainly the H. pylori is something to keep in mind for the future, though.