For Dr Kadwa or Joe De Livera - need help with a toddler after stomach virus (with reflux and having had extensive bowel surgery)Good morning,
I need some help with my daughter (3yrs). In 2010, she had 7 surgeries related to Hirschsprung's disease and had her entire large intestine removed. She had a re-anastimosis (they hooked up her small intestine to her anus) and she has been doing well since Feb 2011 (her last surgery to reverse her ileostomy). Currently she is tube fed formula for 99% of nutrition. She has no physical issues eating, but some serious complications and hospital stays in 2010/2011 has put her off eating again (she was almost weaned and eating entirely orally prior to August 2010). She is also on replacement hormones (hydrocortisone, growth hormone and thyroid) daily because her pituitary gland didn't fully form. She's been on these since she was 3days old.
She's a fairly healthy kid despite what she's been through. However, when she does get sick, it rocks what's left of her guts. Here's my issue.
2 weeks ago, she got a stomach virus. It's the first time she's been sick in over a year. It lasted about 3 days. I was giving her pedialyte and a sugar-water mixture (she has issues with hypoglycemia). She could not tolerate milk or formula.
However, since then, I cannot get her to keep anything more than a few ounces down of formula (it's lactose-free). She had reflux before her bowel surgeries (because she was so backed up). But it only shows itself now after she had a cold.
Now, the reflux is back in force. If I give her more than 4-5oz at a time, everything comes back up within a 1/2 hour.
I have been using the Nat Phos 30x (2tabs after each feed) and Nux 30C (3tabs) as needed with her. They help, but we're stuck at this 5oz level.
Her usual nutrition intake is 30-35oz daily (3-10+ oz bottles) and whatever she may actually eat orally (usually stage 2 baby food, 1-2oz total). I've JUST been able to get her back to getting 30oz into her, but it's broken up over 6-7 feeds.
Nothing is helping her get over this hump. I suspect she also has a full-body yeast infection (it usually happens after she's been sick). Currently, she has thrush in/around the mouth, severe diaper rash and I believe it's part of what contributes to the reflux. The only thing that works to rid her of the yeast is a Rx for Diflucan.
I have also been giving her probiotics (and this is something that she usually gets) one capsule dissolved in her formula daily or every other day.
Throughout this whole ordeal, she has been exceptionally irritable (obviously) and not her normal, playful, happy self. For a couple of days, she was so miserable she wasn't getting good sleep, but that is getting better and she is now sleeping through the night again.
A couple of things are odd with this episode though. Her hands and feet are like ice all the time. She has been requesting socks and shoes (which is unusual...she normally pulls socks off and wants to be barefoot). She's also taken to pulling her hair out (this happened once in the hospital when she was coming off narcotics). She has been on no medication (save for a few doses of tylenol) besides her hormone meds. Also, her guts growl loudly after and between feeds. This isn't necessarily unusual for her, but it normally doesn't cause distress. Now, however, she reacts as if it's painful.
Any help would be greatly appreciated...she's really having a hard time and all my 'normal' stuff that usually works wonders (the Nat Phos and Nux) aren't cutting it this time. There's something else going on and I'm at a loss.
dawnb122200 on 2012-02-27
Natrum Phos 30x may be continued.
♡ kadwa 8 years ago
Thanks again! I'll let you know how she does.
dawnb122200 8 years ago
I just wanted to give you an update on my daughter. Dr. Kadwa recommended Carbo Veg added to the Nat Phos protocol and occasional Nux Vomica I had been using to try and get her reflux under control.
I ended up using 30X because I could not immediately get 30C in our area. I gave her doses morning and evening for 4 days. Her reflux cleared up almost immediately and after 2 days of the Carbo, I was able to begin giving her full bolus feeds again.
The last day that I gave her either the Carbo Veg or the Nat Phos was on Sat, March 3rd in the evening.
Since then, she has been getting back to her normal disposition. Her sleep patterns have improved. She has started playing again. But she is only still wanting to take a couple of sips of milk or water and refuses to eat any food.
Just in the last 2 days, she's been experiencing fevers. They have been between 101.5 and 102.3 (which are high for her). We monitor her temp carefully because when she does spike a fever, we need to stress dose her with the hydrocortisone so her body can react to the stress of the fever.
I use an ear thermometer and her left ear is usually at least a degree higher than her right (or the fever only registers in her left ear and she's normal in her right).
She is showing no signs of earache or ear infection (she has tubes, and there has been no drainage).
I was wondering if there is anything to the fever. She is showing no other signs of sickness (congestion, etc.) but she has been asking to go to sleep more frequently.
Any suggestions would be greatly appreciated. And again, thank you for the Carbo Veg recommendation, she feels so much better now that the reflux is gone. We really appreciate the help!
dawnb122200 8 years ago
I am delighted to learn that your 3 year old responded to the Carbo Veg 30x which you gave her although Kadwa had prescribed the 30c.
I do not think that the 30c would have helped her in the manner that the 30x did. You can safely continue with both the Nat Phos 6x and the Carbo Veg 30x and report progress which I shall monitor.
I am concerned about her temperature and I would not like you to use the 'Ear' thermometer as there is some danger of it damaging the eardrum. Stick it under the arm and add 1 degree to check her temperature.
I would suggest that you consult your surgeon for advice on an antibiotic if this fever continues as you cannot take a chance with your daughter.
♡ Joe De Livera 8 years ago
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