Sunday, February 20, 2011

Gerd is the Word

GERD is a very common preemie problem.  Its not limited to preemies of course.  Noah had what I would now call a touch of reflux - that kid wore a bib over every outfit until he was a year old.  Whenever he got his picture taken, we would quick, take his bib off to snap the picture, and immediately replace it.  And we thought that was "bad" reflux.  Turns out he didn't even hold a candle to his baby sister.

I want to point out that I am in no way exaggerating this. 

I am being very literal here.

Campbell would spit up entire feedings with such force it would come out both her mouth and nose.

It would soak everything: outfits (hers and ours), bedding, carseat, furniture, carpet, you name it.

It would back up into her nasal cannula.  It was thick and gross, and it would clog her airway and she would desaturate.  She required suction to clear her airway most times.

It was also painful for Campbell, and even if nothing was actually coming all the way up and out, we could tell the acid was coming up far enough in her esophagus to make her grimace and hold her breath, also causing her to desat.

We did everything we could to help our little GERD baby.  Her feeds were thickened, which added weight to the contents in her stomach.  The idea is that gravity would help keep it down.  She was on reflux medication, which didn't do anything for the actual spitting up, but it would help to make it less painful.  We needed to avoid laying her laying flat on her back because that caused the acid to come up, making the reflux worse.  And sitting up put pressure on her belly, making the reflux worse. 

So what do you do with a baby who can't lay down and can't sit up? 

Well, she spent a lot of time propped up on a boppy.  And Eric's dad made a support for her bassinet mattress so she could lay at an angle. 

But putting her in her carseat was the worst.  Which was obviously a necessary evil.  The angle put just enough pressure on her belly to make her lose her lunch.  Every time.  We anticipated it, so whenever we were getting ready to leave the house and getting her in her seat, we were ready with the neccessary clean-up items. 

After a few months of this, when I didn't think I could take any more, I asked our pediatrician how long it would go on. 

He replied, If I tell you, you have to promise not to hit me.

He then explained that GERD doesn't usually get better until kids are standing up and walking. 

I did not hit him.  But I felt sick to my own stomach.

We dealt with this multiple times a day for many, many months. Once we were out of hibernation, and back out into the outside world with our babies, we grossed out many people.  Our pediatrician once described GERD as "socially unacceptable."  Yeah, I'll say.  We sent many people running away in horror after stopping to ooh and ahh over my adorable twins, only to witness the blue eyed one projectile vomit all over everything.  I heard a lot of "Thats not normal" and "You need to call your doctor" when passerbys stopped to gawk as I got her all suctioned out and cleaned up.

And her reflux caused more than just social awkwardness and boatloads of laundry.  It was so bad that it was affecting her feedings and subsequently, her weight gain.  There for a while we were making weekly trips to the pediatrician because he was very concerned about her weight.

We were referred to a pediatric gastroenterologist for more testing.  He was concerned about a possible anatomical problem, but all of her tests came back normal.  He changed her medication and put her on pediasure for extra calories, which seemed to help her gain weight.

We also started seeing a speech pathologist for feeding therapy because she was fighting through her bottles and would refuse anything on a spoon. 

She just hated eating.  It was awful.

We worked with her GI and speech path on therapies because part of her problem with eating was now a learned behavior.  See, over time she learned that eating would cause refluxing (translation: pain) and so apparently her logic was if she didn't eat, it wouldn't hurt.  I learned many tips and tricks to get her to eat, and how to sneak in extra calories.

After about a year, the reflux finally started to taper a bit.  She got down to only vomiting about once a day, which was "nice."  And now, at eighteen months, I safely say that she has not spit up in several months!  I think it is due to a combination of therapy, medicine, and slowly outgrowing the reflux. 

Thank you God!

Once again, I am reminded how lucky we are to live near Peoria, where we have access to these amazing pediatric specialists and therapists.  I know sometimes families drive hours to get access to these doctors, and here they are right in our backyard. 

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