Showing posts with label respiratory. Show all posts
Showing posts with label respiratory. Show all posts

Friday, December 23, 2011

Forever Guessing

While we have more answers after GAPS than we do prior, there are still some times we have to just shrug and move on. Sometimes we just have no idea because there are too many factors. This time we are forced to stop and figure it out.

Last week Ellie had a fever and developed respiratory problems. She is still recovering. I blamed the pork. Then I thought it might be the elk broth which I had assumed was safe. Then her older sister got croup, and the age old question 'is this her first confirmed virus' surfaced again.

Investigation revealed the elk came from a ranch where they were supplemented with hay over the summer by staff. Stupid hay. Hay is an undefined combination of grasses used to feed animals. Hay is not a specific type of grass. Hay could be corn, or who knows what else. Stupid hay.

So now we wait for the symptoms to go away, and try to make a decision: retry the Elk or move on. Retry Elk and she fails shows us it was the elk, and will free up quite a bit of freezer space. Retry Elk and pass, and she has had her first confirmed virus, an amazing reassurance that her immune system is healing.

Normally the decision is not that hard. One wonderful thing about GAPS is that we generally don't talk in terms of food fails anymore. Instead, we say she isn't ready...YET. This time the decision feels different because she is begging for food and I want to get a move on. And we don't normally have hard respiratory reactions like this. In fact, this is the first since starting GAPS, which petrifies me that corn is indeed the culprit.

Corn. The one thing that may never go away.

Saturday, April 30, 2011

Her First Antibiotics

We were making fantastic progress with Ellie on the bone broths and meats. Thanks to the many blessings of others we have been able to provide her with just about every bone broth imaginable. Each animal has a different diet and provides different nutrients. We often think of this when eating the staples fish, beef, or chicken. We don't often think of the other meats as offering even more.

Once she had been on the bone broth and boiled, pureed meats for a couple of weeks we began the process of introducing vegetables. We used the GAPS introduction diet as our guide. We started with de-seeded, skinned, boiled green zucchini. Removing the seeds and skin helped take out any fibrous parts that would irritate and inflame her healing intestines.

We then moved on to onion. She didn't seem to do great, but we moved forward. I added in carrot, and threw in a little garlic. I could have added them in too quickly. The onion could have been too fibrous. The carrot could have been too sweet. The garlic too starchy. Or perhaps I just got to excited at the idea of her eating food. Whatever it was, we had our first 'fail' since the start of broths. And it seemed to hinge largely around the carrot.

At this point I realized things were different. It as not a typical, confusing, and extreme FPIES reaction like we had seen in the past. And I began to understand that what I was seeing was an intolerance - the inability for her body to handle a particular food. And the differences between FPIES, intolerances, and allergies began to make sense.

I removed the garlic and carrot, but she did not heal. I removed the onion and still no improvement. With just zucchini we began to see respiratory symptoms. Back on just the broth and meat. And a low grade fever.

Off to the pediatrician we went. Diagnosis: sinus infection and ear infection from reflux. Treatment: Her first ever round of antibiotics. 10 days of compounded amoxicillian (sp?). A slight increase in her probiotic. And a surprise. No typical antibiotic diarrhea. Or constipation. Or problems. Instead we saw a white tongue, return of full body eczema, and an otherwise very happy toddler.

Interesting. Antibiotic therapy is used to treat colitis and intestinal disorders....sometimes.

The white tongue and eczema was fungus overgrowth. Compounded powder nystatin was added to her mix.

And she got better. Zucchini back in, and moving forward again.

Tuesday, February 15, 2011

Ellie Had a Little Lamb!

While cleaning the freezer I was excited to find a few jars of beef broth that looked unbroken. This was great news since we were out of lamb and fish. I very carefully removed three unbroken mason jars of beef broth from my garage freezer, and being careful not to bump them on anything, I placed them in our bathtub to thaw. I was able to save them, so I did not have to make beef broth again right away. My mom was kind enough to make the fish broth for me the first time, and offered to make it again, which helped restock my broths. All I had to remake immediately was the lamb.

I was worried I would over do the beef broth if I did not rotate them enough, so we put her back onto formula and almond milk for two days. In an effort to get caught up.....here is a quick synopsis:

Adding the formula back in confirmed that it has been causing symptoms for Elianna. Her reflux and upper respiratory symptoms returned quickly, and I am now convinced that the corn based formula has caused her body to be in a state of inflammation for her entire little life.

The almond milk has not sustained her, and was causing her to be malnourished. This was a horrible recommendation by the doctors, who in their defense, have nothing other than trial and error to guide them. She needs the calories and additional nutrients that the formula provides while we transition her off and onto the GAPs introduction diet (with modifications).

We went one more round of broths: one day beef, one day lamb, one day fish. The results were fantastic! NO signs of reaction or symptoms. We eliminated the almond milk from her bottle entirely, and today we took a BIG STEP!

I made the lamb bone broth, and then pureed up the meat, bone marrow, fat, and other parts we have come to know as 'icky'. I poured the broth into small mason jars, and then added 2 rounded tablespoons of the lamb meat puree to each jar. Once shook up, it completely dissolved into the broth, making it possible to feed her in her bottle. And today that is what she ate! Correction: she CHOWED!

I was really worried that she would be turned off by the texture and that I would not be able to get it liquefied enough with my regular-joe-blender, but she did not seem to mind, and I think she even liked it! Let's hope the other meats blend up that easily.

To complicate matters and make the guessing game more fun (sarcasm there), she contracted a virus this week, and two nights ago her fever reached 104. Thankfully we have some corn-free compounded acetaminophen and ibuprofen in our cupboards, which brought it down to 100. After two late nights battling fever, the lamb broth with puree and some added formula was her drug of choice today. I feared that the amount she ingested would increase her chance for reaction and we would be in horrible shape by tonight. She drank almost 60 ounces of broth just during the day today, with a nap from 11:30 to 3:45! I was so afraid she would wake up screaming or that it was the start of a reaction, but when she woke up she looked better than she has looked, well...ever! With the bottles and the puree we let her paw at in her highchair at dinner, she ate about 4 teaspoons of lamb puree today.

MY FPIES BABY IS EATING MEAT!

Sunday, February 6, 2011

Fearful Mommy: part 1

Since we knew Elianna's formula was keeping her from getting completely better (to baseline), when we introduced almond milk we also lowered the amount of formula we were giving her to help make sure it was a successful pass. Once we determined it was safe, we went back to 100% formula and moved on to the next trial.

Over the next couple weeks there were a lot of complications, but I couldn't help feeling as if something was just a little not right, and after going back on to the formula 100% she was actually worse. I knew that when you remove a food trigger and then reintroduce it the symptoms could be worse or more immediate because T-cells can identify it faster. I kept shrugging it off, but then over the next three weeks, this added to a couple of other fails, and she just didn't get any better.

For the first time ever her weight started to decline very slightly, her respiratory symptoms were horrible, and we were even failing diaper cream on her butt. This was not boding well. We returned to the allergist who continued with the original instructions: pass almond milk and then transition her off the formula entirely. The concept that her intestines were not going to heal entirely, and that she may not pass any other foods while still on the corn based formula, was one that I could understand in my head. However, the idea of putting my 18 month old on a diet of home made almond milk, and a teaspoon or so of fruit at dinner, was not a very comforting thought. This had to be insane. But the plan was to move quickly and get other foods into her diet. For a child with sensory and food issues this was a lot to expect, and I was spending a lot of fearful time on my knees praying.

I waited until the following week when we went back to see the GI and the nutritionist, so that I could ask if this plan was as insane as I thought. Truly, could an 18 month old survive on only almond milk? Surely not. My mommy instincts were going through the roof. The GI tried to reassure me by saying that 80% of a child's calories between 12 and 24 months of age come from milk (ok but that is for kids who eat food right?), and the nutritionist said that it would be low in protein, so if I could trial and add hemp milk, then lamb, and a gummy multi-vitamin that he recommended, we would be good to go.

Wow. That seemed like a good plan, but a lot of steps to conquer. And could we do it quick enough to not be detrimental to her health? Again I was reassured that she has never had failure to thrive and definitely is in good enough condition to go a month without worrying that she isn't getting her daily recommended nutrition.

A MONTH.

That certainly did not sit well with this mama. A month of transitioning off of the formula, and onto only home made almond milk, while trialling these other new foods? What if she failed one? What if she needed weeks to heal?

What about the fact that she was not healed to begin with and I listened to her cough up her lungs and wake up screaming for air every night?!?

I prayed, and I fretted, and I researched, and I consulted others that I could trust, and the answer was all the same: no one could tell me what the answer was, and the doctors were giving me what they felt to be the best answer. I called and spoke with the pediatrician who gave me an immediate referral to the top pediatric nutritionist at the local hospital, but it would take time to be processed and get in. How long?

The following week her symptoms of illness continued, and we decided to take the plunge. I began making almond milk, and we began the transition. And I was afraid.

I was afraid for her nutrition, I was afraid for a possible reaction once she was on that much almond milk, and I was afraid that if we had to go back to the formula we would not be able to.

Thursday, January 27, 2011

Ain't Nothin Urgent About Urgent Care

I have heard many horror stories from other FPIES and PI moms about doctors and hospital visits. We have been blessed with a fantastic pediatrician who sent us right away to a fantastic GI, and so we have had very minimal bad experiences. Just to make sure I can relate to those other moms, we were allowed to have a couple of those experiences this month.

The third weekend in January we were approaching the end of the fourth week of Elianna's respiratory problems. She had been on the nebulizer at night for almost three weeks, and by the 21st I was beginning to be afraid for her oxygen levels, especially at night when it was particularly bad. After an extremely hard Saturday night I decided it was time to haul her in to the urgent care provided by our pediatrician's office just to have her checked. What if at this point she had pneumonia?

I knew there was going to be a problem when I called to make the appointment. Every veteran mom knows there are key phrases and words that tell the scheduler to consult an advice nurse immediately, or to at least not make light of the situation. I called Urgent Care as soon as they were open, and told the woman on the line that 'my 18 month old daughter is a patient of Dr. O, and she has been having trouble breathing. I need her to have her oxygen levels checked and have her chest listened to.' 'oh.....o.k.', she answered causally. 'well, my next available appointment is at 11:45. Will you be able to make it here by then?' Duh. Did you hear me say she wasn't BREATHING?

We arrived at urgent care and the nurse welcomed us warmly into the room. 'So you are here for a cough?' she asked. 'Well...no not exactly,' I answered. 'She has been sick for several weeks and was having great trouble breathing last night. I would like to know if it is a bacterial infection or a virus, or just a side effect from her reflux.'

'oh OK,' she was partially listening. 'So..haha...her chart says she is allergic to FOOD and that is a little GENERAL so I am going to need you to be more specific and update things. We also have listed peanuts. Is there anything else you would like to add?' Tick. Tick. In my head I have to make a choice. Explain, or just say no. 'Well, she has a rare condition called FPIES where she actually IS allergic to food.' Silence.

her: 'Oh. OK. Is she on any current medications?'

me: 'She is on albuteral in a nebulizer.'

her: 'Oh. Why is that? There is no diagnosis of asthma in her file.'

me: 'Well, she has a severe corn allergy and that is the only medication she can have without it.'

her: 'Oh so she DOES have a severe allergy, and to corn? I will add that in.'

me: 'Is her diagnosis even IN her file?'

her: *tense laugh* 'Oh I am sure it is, but I am not on that part of the screen. I am in the allergy section.'

me: AAAAAAAAAAGGGGGGGGGGGGGGHHHHHHHHHHHHHHHHHHHHHHHHHHHHH!!

OK not really. That was only going on in my head.

her: 'Well let's measure her oxygen.' *fast forward* 'It's fine. Looks good. Its 98.'

me: 'what should it be?'

her: 'oh, 100.'

me: 'Wow I really should just avoid the co-pays and buy one of those oxygen meters for my home.'

OK. Again. Not really. Just what I was making a mental note of. Ask Dr. O about that and if that is a possibility.

her: 'The doctor will be right in.'

And he was. In he came! He asked me the same questions, and I tried to explain again. And he listened to her chest.

Dr.: 'Sounds clear.'

Elianna: *cough. hack. gag*

Me: 'OK. So it is not a bacteria or a virus?'

Dr.: 'Uh...no normally we see other symptoms with virus or bacteria.'

me: 'so this is a side effect of her reflux?'

Dr.: 'I don't know. You should follow up with your primary care.'

And he exited.

Clearly I chose the wrong profession, because he got PAID for that!

Week by Week, Day by Day

The first week of January Elianna had symptoms of a reaction from a bath soap with wheat protein. By January 4th she was having a typical upper respiratory response to the reaction which looks a lot like a bacterial or viral infection. Off to the pediatrician we went for a nebulizer refill (nebulizer medications do not have corn, while all of the inhalers and asthma medications I have researched do). We ended the almond milk and went back to all formula in an effort to help her get better and eliminate any possible complications. And so ended the first week of January.

Here comes week two. I noticed that Elianna's eczema was the worst it has ever been, and that we truly needed to focus on getting her a safe lotion. That led me to the Eucerin, which she ate during week two. For details on this incident see my previous post here. I finally decided that anyone who ate lotion would not feel very good. I decided to put my energy into finding an oil that might work, and thus we trialled almond oil and it was a pass!! It has not completely fixed the problem, but so far we have seen some good improvement.

With the arrival of week three and no more 'prunus' foods to go with, I was feeling a little bit brave and purchased grape juice from the store. All of her safe foods are now out of season, and the choices are limited. I understood grapes to be one of the few fresh fruits you can buy in the store without the traditional corn, soy or dairy derived coating. Soooooo..... daring the issue of cross-contamination, I handed her a cup of grape juice on Monday morning. After two big gulps and about 10 minutes she began to have a glazed look and just sat in her highchair and stared. This prompted me to get her down, and enlist Jason is the observing. Then the reflux coughing, urping and vomiting started. Nothing projectile but she cried in pain. At about 25 minutes she began pointless running in circles around the kitchen island, which was very bizarre to watch. Around and around and around and around. This lasted for about 5 minutes at which case she stopped and we noticed that her face and around her eyes were getting puffy. We stood and watched her eyes swell within a matter of minutes. Another 20 minutes later it seemed to decrease and she was feeling better. Except her eczema was bright red and raised all over her body, almost like hives. Truly bizarre and unlike the reactions we have had prior.

Hooray for January. And, oh, yeah.....that was just the start.

Wednesday, January 5, 2011

Almonds, Soap, and Diapers, oh my!

With the holidays and some new developments, things have been BUSY around here! Here is an update:
We took the leap to cloth diapers to help with Elianna's eternal diaper rash that resembles a burn and looks strangely like her reactions to her patch testing.

We trialled homemade almond milk. Its super easy to make (recipe here).

We began using soap on her in the bath - organic shampoo/body wash in one. We used it maybe three times at the end of her bath with a quick wash and rinse with the hand held shower wand.

After a week of documenting and watching, we called almond milk a pass (hooray!) but there were some other signs of reaction. The diaper rash returned and her eczema became worse than ever. The questions began. Was it the almonds after all with a delay onset reaction? Was it the bath soap? Was it the new diapers? Was it how I washed the diapers? Or the diaper fabric? This method of questioning is common and some days makes me insane!

In desperation I read the back of the shampoo bottle once more and found what I had missed - wheat protein. CRAP! How did I do that? A call to a girlfriend who battles Celiacs confirmed what I already knew; your skin is your largest organ and absorbs what it touches. Back to 1/4 cup baking soda only, and a lot of prayers that this was the cause of some reflux, pain, and what looked like the start of a full blown reaction. Please please don't be the almonds!

After three days it resolved itself. WHEW. Dumb mommy! But now we have the additional delayed response - sinus congestion, drainage, and raspy asthmatic type cough. It's working it's way out of her system, and I am SO happy it was not almonds. Who needs bath soap anyways?

On to trialling the actual almond nut now!