Sorry this is so late in coming. We talked with the doctor from the specialist's clinic after the test yesterday and this morning, but literally everything he has said has been contradicted by the attending, so we didn't want to confuse things. Unfortunately, we literally did not see the attending until after 6:30 this evening.
Once he got there, we asked him to explain to us very carefully why Isaac is in the hospital because we are still confused about that. He went over Isaac's CT scan with us and pointed out some areas of concern. This included some pockets that appeared to have some mucous or something in them, though when they looked at them more closely in the bronchoscopy yesterday, they didn't find much of anything except minor inflammation.
He continued to talk about how he thought this really was a case of aspiration of food. We asked why, since Isaac hasn't ever displayed symptoms of it before -- literally hardly any coughing, definitely no frequent spitting up, and his doctor hadn't said anything about hearing any problems in his lungs at any of his checkups (plus, he saw the breathing specialist at the practice twice, and she didn't either). We asked why not reflux since that seemed more probable to us. Even though he doesn't really ever spit up, since we've started talking about it, we did realize that his cue that he didn't want to eat right then was to arch his back, which is a symptom of reflux. Plus, I have it.
It got a little weird because Judah and I had separate conversations with him. We tried to both go out in the hall to look at the CT scan, but Isaac wasn't happy being left alone in his crib, so I went back in and then we switched.
I had earlier asked if there was a possibility that the crackling in the lungs going away and coming back would have to do with Isaac getting over the bug he had when we got there and then catching something else. Dr. didn't seem to think that was it. Later, when he was showing me the scan, I asked if he would consider the timeline again. Two weekends ago, Friday through Monday night/Tuesday morning, Isaac had a bad stomach bug and threw up multiple times, which was his first real bout with throwing up vs. spitting up. Wednesday morning, when he finally was over the puking, he woke up with this congestion, which was the congestion he had Thursday when we went to the specialist appointment that landed him in the hospital. (Actually, now that I am writing this, I am realizing, too, that the crackling returned after he threw up after his albuterol treatment the other night. Hmmmm ...) So was it a possibility that he had aspirated then -- during the vomiting -- and was not aspirating every time he eats?
So the current plan is to start him on Prednisone and antibiotics tonight and try to calm the inflammation and get rid of anything bacterial in his lungs, then see how he does with bottle feeding again, then hopefully get out.
We are just supremely frustrated because they are fixated on aspiration and that we have to avoid all possibility of it -- they keep mentioning a G-tube as the easiest way to get him home faster. We would like to avoid that at all costs because it really does seem like there are simpler explanations to be had. And, oh yeah, there is the part where Isaac has been doing fine for the past 7.5 months.
Long story short, it was a supremely frustrating day, but at least we have a semi-semblance of plan for the next couple of days. Once they are convinced he can eat OK, I think they will let us out. So keep your fingers crossed that the prednisone and antibiotics kick whatever this nastiness is that is complicating things so he can eat again and we can leave!
At least despite the stressful situations, you're still asking detailed questions and challenging the doctors. I think too many people give in. Hang in there!
Posted by: Marci Phillips | February 07, 2009 at 11:05 AM