Tag Archives: periactin

Lions, Tigers and Bears, Oh My!

Ok, so no lions, or tigers, or bears 😦 But, ENT, Ortho, and Corn Starch, Oh My didn’t have quite the same ring to it. Busy week around here. Already filled you in on the GI appt, but yesterday we saw the ENT and an Orthopedic specialist.

The ENT visit was just a follow-up to check on Braxton’s ear tubes. He’s had one ear infection since having them placed in April, but no big deal there. Doc said unless it becomes one every couple of weeks there is no concern. As for the sinuses, the Doctor said that at this point going in and probing them really wouldn’t help Braxton. Yes, they *could* do it, but since Braxton’s sinuses are still pretty small there would be very little benefit and having to put him under to do it really isn’t worth it. He also mentioned removing Braxton’s adenoids to help the congestion, but that’s also not truly necessary at this point. With everything else Brax has going on, especially feeding wise, fixing one problem could actually create an even bigger problem. So no additional surgery. Yay.

We also had our first visit with an Orthopedic Specialist to basically get a baseline for his hip and spine. Back in August when Braxton had pneumonia, the chest x-ray noted mild scoliosis. His pediatrician felt it was also necessary to check his hips to rule out hip dysplasia or other issues.  The hip x-ray did note  some delayed developmental hip dysplasia, but really all that means is that right now one side is not as developed as the other. As for the scoliosis, the Ortho did say it was mild for Brax. About a 16 degree curve, but unless it gets to 50 degrees there isn’t anything they would do for it. He recommended in the future for us to maybe do a CT scan to get a better look at the spine to see if any of the vertebrae are not fully formed or fused together, but he’s not concerned with that for now. Basically, for both his hips or spine if either progresses we’d look into splinting or braces before surgery. This also means there is no reason for Braxton to not be able to walk and continue to progress developmentally. Yay, more good news! Definitely one of our better days, appointment wise 🙂

And finally, the corn starch. Who knew?! So far the corn starch has been GREAT!! We’ve increased Braxton to 8 ounce feeds, 4 times a day and have been able to run his feeding pump fast enough to finish the feed in 30 minutes. We have NOT been able to do that in MONTHS!! I am sooo thankful this is working. We are continuing to slowly speed up the pump and eventually take him off of it again.  The periactin doesn’t seem to have kicked his appetite into gear yet, but I know it’s a process. Trying little by little to feed Braxton by mouth and get him back to eating table foods.

So, it’s been a very busy, but overall, a GREAT week for Braxton! We. Are. Thrilled!

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Gastric Dumping Syndrome

Well, this post was pre-empted by yesterday’s exciting events! But, if I don’t write it now I’ll forget. Mommy brain.  Yesterday, Braxton had an appointment with his GI doctor to discuss results of his Gastric Emptying Scan and follow-up on feeding difficulties.

The test was originally done to check for gastroparesis – delayed emptying of the stomach, which the doctor thought could have been brought on due to the pneumonia Braxton had in August. The scan actually revealed the exact opposite! GI has determined that Braxton has Gastric Dumping Syndrome. I’m not going to explain this nearly as well a our doctor did, but here goes… the short answer is Dumping Syndrome is where the stomach empties too quickly. Doesn’t seem like a big deal, but it really is – when the stomach empties too fast the formula gets to the small intestine too soon which signals the pancreas to increase the amount of insulin the body is producing. [Didn’t think you were going to get a science lesson today, did ya?]  His body then absorbs the sugar of the meal way too quickly while his body is also producing insulin. As the level of insulin increases the sugar level peaks and then crashes which can cause vomiting/diarrhea/sweating/lethargy [all problems Brax has had during/after feeds]  This would explain the vomiting Braxton has had when feeding. There is “early” dumping where symptoms can start immediately with feeding and “late” dumping where symptoms don’t happen for 1-3 hours after feeding. Braxton has had both; there are times when he’ll vomit IMMEDIATELY upon starting a feed and times where it’s about an hour later.

So, how do we fix it?

Thankfully, it’s a pretty easy fix. The vomiting is caused by the rapid increase then rapid decrease of sugar levels in the body, so the doctor wants us to add corn starch to each feed. I know what you’re thinking – corn starch?? Well, corn starch is a complex sugar that takes the body much longer to digest and absorb. It also thickens the feed so it moves more slowly through the digestive system.  Since the body won’t be able to absorb the sugar so quickly, this *should* stop the vomiting and we *should* be able to increase rate of feeding and get Brax back to where he was before this big mess. The doctor said “I’m confident this WILL work….I hope” gee thanks doc! =/ He really wants us to work up to feeding Brax 8 oz [he’s currently at 6oz] per feed and get him off the pump again. 

Last night I did try the corn starch and gave him his usual 8oz for the evening feed, but instead of doing it slowly, I ran it at slightly higher than his day feeds annnnnd he kept it down! wooooo!! No coughing, no gagging, no vomiting. So, maybe..juust maybe we’ve finally got this thing figured out! Today, I sent him to daycare with just 7 ounces each feed, just in case it didn’t work as well.  I’m going to very slowly jump the speed of the pump everyday until we can try to get him off of it. 

Also, with regard to actually feeding by mouth. GI would like us to try Braxton on Periactin. Periactin is a medicine that helps to increase appetite and also helps to expand the stomach. GI’s goal with this is to MAKE Braxton hungry so he’ll WANT to eat by mouth again. He said the effects of it wear off after a few weeks so we’ll have to do cycles. Give the medicine for 3 weeks, give him a week break, then start him on it again.  As an added bonus, Periactin is an antihistamine so hopefully it will also help Braxton with all the added congestion he has going on. We see the Ear, Nose and Throat doctor tomorrow and I’m going to bring up the persistent sinus congestion and see what he thinks about going in and cleaning the sinuses out or maybe just seeing what the Periactin does.

*fingers crossed*

Let’s hope this plan works!

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