Pediatric GI doctor (or how I learned to stop worrying and learn to love formula)

References to Dr Strangelove aside, today we did meet with a pediatric GI doctor for the first time.  This after our Pediatrician (who seems like a really great doctor and a generally good guy) was able to get us in on short notice after seeing him yesterday and finding out Q had gained exactly bupkis over the past 2 weeks.  That failure along with the prolonged screaming fits (mostly by Quinn) and him bowing and arching his back after feeds seems to point to the current regimen being profoundly unsuccessful.

So the GI doc listened to us and basically said she wasn't sure why he wasn't gaining with all the interventions, but did put a plan in place.  Also they want to look at his blood, his stool, and his urine.  Whatever your thoughts are on managed care or HMOs, I have to say that I have been never less than impressed with every practitioner we have met on the pediatric side and adult medicine.  I also can't say that I have ever waited an undo amount of time to see them (dental is another story however) nor have I ever felt like they in some way 'skimping' by withholding tests or therapies.  My experience with Kaiser has been universally impressive, but I digress.  The plan is to switch him to formula only, one that has a form of more broken down proteins that should be easier to digest while we await the results of his labs and work on collecting the other samples.

Obviously, we had hoped to successfully breastfeed longer.  However, 4.5 months is nothing to shake a stick at.  And, there remains the possibility (however slight) that Q might return to it.  That said, if this works and takes care of even 50% of his misery (and ours) I will only question why we didn't abandon the breast earlier.  This might even allow Tia to sleep more (although it will cost me some) because she won't be solely responsible for his feeding.  As with all things, time will tell and I will write about it as we move along.  In the meantime, Q is napping so I ought to do the same.

  

In Diane we trust

There are days when we think we have 'cracked the code.'  Q wakes up, eats, plays, and naps without much fuss and without extensive effort.  He is mostly smiles those days.  However, those moments ultimately prove fleeting and we end up frustrated and utterly exhausted again and again.  We have seen a number of doctors, consultants, and the like without any real progress.  The questions vary, but the answers are always the same: this will pass.  As to when it will pass, well, the answer is pretty consistent there as well: eventually.  But if anyone has dealt with a colicky baby you know that all time is not created equally and a day can seem like a lifetime when he is wailing away and you have no answers left but to set him down and let him do so hoping that eventually he will wear himself out and go to sleep.

We believe that the answer is his stomach or, more accurately, his GI system.  Though he is medicated against reflux and takes probiotics, we are gravitating towards possible allergies.  Or perhaps we are grasping at them.  What is clear is that what we are doing now isn't solving anything.  For every day he is happy and content, there are two where we openly question our decision to have a child in the first place (or at the very least I do).  We knew it wouldn't be easy and that things would change, but we did not expect to be anxious about coming home and hoping and praying that the other one has things under control that day or that moment.  What is true is that we are probably shedding nearly as many tears as Q is.

Thankfully, through all of this, Diane has been there to help.  I wish my parents were nearby as well, because the more help we can get the better at this point.  Yesterday, she took Q for the day and Tia and I got out to see a movie and run a few errands.  All told, we had probably 5 hours on our own.  It was like finally being able to breath again.  We are both so grateful for her help and both so wary of asking for too much of it lest we put too much burden upon her.  But honestly, I don't know what we would do without her.

Speaking of Q, he is stirring once again.   Wish us luck if you've any to spare.

4 months and its dark when I get home

Q just turned 4 months old.  Depending on the day, 4 months seems both infinitely shorter than or further from that date.  I thought I might try to encapsulate the experience, but the task feels nigh impossible and always colored by my own mental state at any particular moment in time.  The best I can muster is something I heard from a patient of mine, “You will experience the highest highs and the lowest lows as a parent.”  A truer statement may have never been uttered.    

I don’t think I have ever felt as tired as I have at points in the last 4 months.  Nor have I so regularly felt helpless and inept.  Raising a baby is very very difficult.  I know that all experiences are different and that some are undoubtedly easier than Q is to deal with (and from working in a hospital, I can see the extreme other side of that coin as well), but for every smile and happy moment there seems to be a an equivalent number of spine rattling screams that sounds (in my head) like a cat in heat getting attacked by a wolverine on top of a chalkboard.  You can’t help but feel badly for the little guy as he is in obvious discomfort (as opposed to just being sadistic), but man alive does that yell cut to the very core of you.  Wine consumption has a very strong inverse relationship with his happiness during the day.        

The time change has also managed to kick our collective asses.  Q seems to have the same grasp on it as our cats do….namely that the sun rises and sets earlier than it did, therefore I must do the same.  This would be difficult if he slept until 7 before and shifted to 6.  But, unfortunately for us, he only ever used to sleep until 6/630.  It has been brutal.  By the time I get to work now, I have generally already been up for 3 hours.  His witching hour has also moved up to about 5/530 as he is ready for bed by 6.  We have been trying to keep him up a bit past that in hopes of delaying his AM wake up, but this is akin to poking an angry bear with a short stick in that you will pay royally and pretty much immediately for the decision.  I know this isn’t just an issue for us; all the kids at his daycare are going through similar straights.  I am sure if lawmakers all had little ones when the vote came up, we would all just mimic Arizona and Hawaii and say. “screw it, leave the damn clocks alone!” 

Other than that, my job seems to have finally employed someone to take over the clinic from me.  She starts her new employee orientation on the 12^th (next Monday) and then will take an additional week (or thereabouts) for EPIC training followed by 2 weeks at the Park.  My guess is she will start up here sometime around the first or second week in December.  Then I will train her for another week or two before…well, before who knows what really.  I suspect I will kind of float about as need warrants vs. being exclusively at the Park, but maybe not. 

It is bittersweet really, but ultimately necessary since they don’t have anyone to regularly fill in when I am not here (and aren’t interested in doing so).  Just yesterday when I came in I saw that a 3 year old had been seen in the clinic.  There was an accompanying note to the effect that they are coming next week (and in perpetuity) and that I will need to coordinate this with our pediatric nurse who will have to be pulled from the floor to attend to this patient.  The doctor would be faxing further notes.  I then asked the charge who had run the clinic that day, “So why didn’t they just go to the pediatric clinic?” to which she responded, “We have one of those?”   And that, in a nutshell, is why we need someone here full time I guess.  Between people not knowing how to check orders, make appointments, seeing patients outside the parameters of our clinic, and on and on…we need someone who can take ownership of these things.  That isn’t to cast blame on the charge or anyone else who works the clinic in my stead, they are doing the best they can with limited knowledge and understanding and exactly NO time allocated by management to learn or be trained.  Like building IKEA furniture without directions, you might eventually build it, but it will take a whole lot longer, there will be a lot more mistakes and you are like as not to have a handful of extra parts. 

We finished up refinancing our house recently as well and I think I have never been more confused.   This is mercifully a pleasant confusion.  We sold back points at close so we wouldn’t have to pay as much out of pocket (with the understanding that this creates a higher total payback, but as we have no intention of living there for 10 years let alone 30, this is a minor factor) and had to bring something like $3500 to close plus the cost of the appraisal ($450).  We figured to be out a few hundred dollars when all was said and done in exchange for a lower house payment that would make up that cost within 2-3 months.  Instead, we have gotten back nearly $1000 above what we paid.  It is all HUGELY confusing.  Suffice to say, we are holding on to the money until we can be sure that it doesn’t need to go back out to somewhere.  As I said, it has been pleasantly confusing…with the possibility of aggravating very much in play.  

Other than that, Yay for the country voting against rape apologists and for the rights of women, the underserved, and a shot at a future that isn’t being sold off wholesale in exchange for profits today.  Oh yeah, also yay for feeling optimistic about our government for once (you know, until they get back in session and gridlock reigns again).