"Mother's are meant to nurture, and fathers to protect. It is so obvious how this [FPIES] would wreak havoc on those roles. Dads have their own mind trip of not being able to protect and fix this. And we hurt so terribly for our babies..." (thanks Nichole!)
More words from other FPIES moms. We all echo the same thing in one form or another...the moms going through the same mind games of not being able to play our role.
We, moms want to nurture - we need to nuture, our babies. Our babies wouldn't be here if we didn't have this drive. The drive to stay up all night with a crying baby, to find them nourishment for their body- whether that be a formula that can tolerate, or an elimination diet to nurse them, to push through when we're told we're over-reacting or crazy, or seeking attention, or first-time moms, or not coping 4th time moms. To push through all of this, to push our own pride to the side and continue on for our children. Or, to leave all of that behind and go it alone....neither the easy choice. Tough decisions to make for the health of our children.
Dad's constant mind games because they only want to protect, protect from this being real, from facing the reality of a chronic illness and what that does to a family structure, to protect both mother and child from unlistening specialists who tell you that you are malnourishing your child, when all you've done is protect them, sacrifice so much for them, and fight for their health and well being.
The reality is dad's can't fix this and mom's can't love it out. FPIES robs the natural order of things. But, to accept that this is where God wants us, that is peace. Our Little man is our gift...well, he's our gift #4, from God. Each of our gifts have continued to give us treasures beyond measure. Right now, we're in a gold mine of treasures with little man....if only we can continue to hold on to our Faith and trust that He knows our inner strength, that He only gives us what we can handle, and that He has his plans for us.
Plans to make me stronger when this was so very hard for so many months to listen to my baby in pain, day and night -- with little to do for him. So that when I was handed something to do- I now can't do enough. I want other moms to know they are not alone, I want to help, I want to provide hope to other families, mostly I want to empower other mom's the way I was empowered when I found FPIES and it FIT what my little man was going through. Empowered when I watched the YouTube video of Jack that could've been a video in my house of Little man, to show me that I was not alone. Empower me when I found a speciality children's hospital to take Little man to get his diagnosis so we could develop an action plan for treatment on this long and windy journey....
Plans to teach me what it really means to advocate for someone, someone who can not speak for themselves. To live outside of your comfort zone, to only think about your baby and nothing else and how to get his voice heard....
Our nuturing isn't being robbed from us, but the rules of the game have changed. Our instincts, our research into our children's illness, our advocacy for best care, our involvement in their every aspect of care. Our monitoring of diapers, and foods, and reactions, and caloric intakes IS nuturing an FPIES child.
Dad's protection hasn't been stolen, but the rules changed on what he is protecting from. Protection from crumbs, from trigger ingestions, from unlistening specialists, protecting the nuturing effects of the mother is probably the best gift he can give his child.
Many days, Little man takes much coaxing to eat. Today was one of those days. A lot of holding, and offering the bottle- hoping this time he will take it, and take a good amount. A lot of time from my day just to make sure I'm taking the time to assure he has taken the caloric intakes he needs to. He doesn't "ask" for his bottle -- I don't think he ever has. But, he has always taken a bottle best from me, he trusts me that way....maybe because he knows I will persist until he takes some, maybe he just enjoys the cuddle time. Today it took a lot of persistance....and nuturing.
Thursday, October 28, 2010
Just Peachy....
It had been a few days since little man had had anything to trial....well, unless you count the sheet rock or wood he keeps "sneaking". Last week, I had picked up nectarine's at a local produce store. I accidentally mixed a peach in with them. Well, maybe it was Divine Intervention as the nectarine's were not very good once I peeled them and I ended up throwing them away -- the last thing I need is to give him spoiled fruit! But the peach went into the fridge, maybe I'll eat it one day....
Well, the other night at dinner- he was "crying" for our food once again. He has done this in stages for the past 8mo....when his gut is inflamed, he doesn't even ask for food. When he is healing, he begs. It is enough to break a mother's heart in a million pieces and some days so hard to not just give him SOMETHING! I caved....I went to the fridge, where I knew the peach was - got a knife and sliced it up for him. I put it in teeny-tiny pieces (the size of his millet puffs) and he picked it up (although slippery) and ate it!! He picked up another piece and ate it!! He tried to eat a bigger piece and gagged on it....but he recovered quickly and went for more. He wanted to hold the peach, touch all aspects of it. He started to get frustrated that he couldn't pick up the pieces fast enough so I cut up a few more pieces and put it in his mesh feeder. He is a little old for a mesh feeder and at first didn't know what to do with it but he got it! He loves peaches!!
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Well, the other night at dinner- he was "crying" for our food once again. He has done this in stages for the past 8mo....when his gut is inflamed, he doesn't even ask for food. When he is healing, he begs. It is enough to break a mother's heart in a million pieces and some days so hard to not just give him SOMETHING! I caved....I went to the fridge, where I knew the peach was - got a knife and sliced it up for him. I put it in teeny-tiny pieces (the size of his millet puffs) and he picked it up (although slippery) and ate it!! He picked up another piece and ate it!! He tried to eat a bigger piece and gagged on it....but he recovered quickly and went for more. He wanted to hold the peach, touch all aspects of it. He started to get frustrated that he couldn't pick up the pieces fast enough so I cut up a few more pieces and put it in his mesh feeder. He is a little old for a mesh feeder and at first didn't know what to do with it but he got it! He loves peaches!!
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That was a big "no-no"- we trialed at night and we let him decide how much he wanted. But I have been so frustrated with his oral aversions and not wanting to trial, and his most interested times to eat are at dinner -- with the family. So, as I've done all along with this crazy illness -- I need to let him guide us a bit here. I've been "throwing" (ok, not quite literally) food at him over the past week- see if I could find something he was interested in, taste and texture. He tried persimmon, liked exploring this (freeze dried) but it came through whole in his diaper the next day and it is red- so that makes me too nervous right now. It is in the date family, so it may be too high fructose load for him to tolerate in large enough quantity's for a true trial anyway. He has tried buckwheat (good flavor if I do say so myself) but spit it out. He tried spinach- gagged and spit it out. Mango's, liked those the first day but won't let me come near him (they may have caused a big of a stomach discomfort as they are high in fructose, and his body has a hard time digesting high sugar load foods). But we have to start somewhere....
So, we've moved on to peaches. The next morning, I gave him what was left of the feeder (after putting it in the freezer all night)-he carried that around all morning and sucked it dry! He was so happy with his new treat!!
The rest of the peach (1/2 of it left), I cooked down and mashed. Little Man's aunt gave me a great idea to try....put the puree in a piping tool (used for decorating) and pipe little dots out on some freezer paper and freeze his puree- so he could have a pureed finger foods. So, that is what I did with the rest of the peach. Last night, while making dinner- I sat him down and gave him his new treat. He gobbled those up faster than I could finish making dinner!! Thanks Aunty M!!!!!
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Now, I was out of prepared peaches, but I had just picked up a few dozen more at the store; so I got some and cut it up like the previous night. He was more interested in the skin!! He wanted to "chew" on the skin! We let him explore it a bit, but I had to stop it soon....there is a spray put on most fresh fruits and veggies for preservation and this spray often contains corn byproducts! So, even if washed- it would be a chance I'm not ready to take yet for him. But it was really great to see him putting something with so much texture in his mouth.....
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So far, so good with peaches....and we celebrate our little victories. Could it be that we are FINALLY building little man a tiny menu?? Peaches are good source of vitamin A and C -- just what he needs!! Also, they even have a bit of iron in them. They would be a perfect addition to his diet. Now if everything else in Little Man's complex care could be "just peachy", we could celebrate more. But for now, I must go and prepare/puree/pipe/slice/freeze the rest of those peaches!!
Monday, October 25, 2010
Navigating through the subspecialty labyrinth....
"...At the same time, it is not surprising that these families fail to successfully navigate the subspecialty labyrinth. The gastroenterologist did the endoscopy and didn’t see much, the biopsy results were underwhelming to the pathologist, and the allergist said the child wasn’t allergic because the skin tests were negative. Random elimination of foods didn’t help. The child is still sick. Now what? Of course, there is no simple solution" from: The Mother of All Food Allergies.
We began the subspecialist labyrinth in Feb. with our referral to GI here, the above passage from this great artcle written about FPIES from a gastroenterologist says exactly our course. Shuffled through GI, an endoscopy with biopsy's, to the allergist and elemental diet with elimination of foods, reintroductions and little man stayed sick.... "no simple solution" doesn't begin to describe the path we've been on for the past 8mo. through the subspeciality labyrinth looking for support for management of this chronic illness.
Today, we hopefully took another turn closer to getting us out of this labyrinth, or at least show us there IS hope and choices and options for treatment, and support to navigate through it...
This gastroenterologist is associated with another (larger) Children's hosptial....so here is one option- we have another option for where little man would be hospitalized should he ever need this again, or for a food challenge (not trial, a challenge of an already known trigger food). This hospital is not in our home, but an hour and half away- which is not ideal but more realistic than half way across the country that it would take for us to return to CHOP (no matter how much we would rather just go there).
The GI started the appointment by explaining how he had read through little man's chart, which is always good. He asked how he could be of help -- being that we've already consulted with allergists and another GI. Management of his FPIES....specifically support is where we need help. He wanted to know his story- when we first started noticing symptoms, when we got help, when we went to Philadelphia....wait, you physically went all the way out to PA? We explained how he seemed familiar but then not-so-familiar milk protein intolerance, but was he reacting to more in my diet? from almost birth and how his reactions to Good Start formula seemed to wake up a colic, then we moved to rice and other solids to try and get a better handle on what we thought was reflux or hunger, or what? Soy formula last fall exacerbated a reflux, and colic. He wanted to know when he had his scope and when we started the elemental formula's. And what the first scope showed and the second, and how long on the elemental at the time of the 2nd scope? And what is he like now? What diet is he on, what does he tolerate. What about this tapioca reaction, that seems out of the typical response? Lots of good questions to get a good understanding of where we have come,what we have tried and where we are going. He was thorough and listening. He said key things like "I certainly don't argue with the parents"....."if they see something, then that is what it is- I don't live in your home so if you tell me something is wrong, I'm not going to deny it".
What did he think of him reacting to the elemental formula? He has never heard of it either....but he listened while we explained how we came to that conclusion and how we didnt' find a baseline until we finally moved away from any and all sources of corn. He didn't dwell on this, instead saying if our Dietitian is following closely and our Pediatrician- than he sees no reason why Little Man can't be on a homemade formula....if we've worked it out for adequate calories, protein, fats and carbohydrates...
We moved on to discuss his anemia. At this point, his concerns would be his protein intakes (getting better iron-rich sources of protein in his diet or formula) and treating his anemia. He wanted to know why we had not done an IV iron transfusion since he does this all the time for his Crohn's patients- and they feel so much better after having it done. He would be in the hospital and the iron would be transfused in him via IV. He fully agreed that he has a risk of reacting to a blood transfusion and agreed it wouldn't be his first choice for little man.
Pause for a moment with me....can you just imagine what it feels like to be in a room of a subspecialist who is acknowledging your son's illness, listening to your concerns and giving you real options for treatments of the complexity of it? And giving you the support that he would oversee this at the Children's hosptial he works with if this needs to be done.
This GI goes on to explain GI's are not typically the main doctors on an FPIES team, that you don't necessarily need the GI outside of needs for scopes. There is little to test for and this can further frustrate a GI doctor who typically operate on diagnostic tests and criteria they can measure. Remember, he is one- so he knows. The good part about this GI, his good friend is the very Allergist we saw last month (Allergist #3 who confirms Allergist #2 diagnosis of FPIES). He even went on to explain how he learned about FPIES.....everyone has to start somewhere....
A mom whose child did not tolerate soy and it was severe reactions to soy, was looking for help- looking to be heard. This doctor thought he had her simple solution- avoid soy. But the mom was noticing pain and other symptoms with introductions of some other foods and did not know how to proceed, for fear of the soy reaction returning. So she visited his waiting room everytime she introduced a new food. Finally, he said they could challenge soy- since she was passing so many other foods. He admitted her to the ER for monitoring, and fed the child soy. A few hours go by and nothing happens. So, he dismisses her- she goes to the parking lot and waits (she knows her child will be having this reaction soon). Sure enough, the "vomiting her brains out" begins and mom brings her back into the ER. The GI doctor was perplexed, called his allergist buddy and asked him if he knew what was going on, he replied...she has FPIES, haven't you heard of this? He hadn't before, now he did.....
This mom's actions and persistance and advocacy for her daughter has made an excellent and helpful, FPIES friendly GI for so many other moms to follow her....I am grateful to her. And I hope her daughter is now outgrown her FPIES and doing well. Maybe someday I can connect with her (goodness knows, I sure have "met" a good share of FPIES mommy's already!).
He continued to take his time with us, discussing our concerns and how he could be of help...I wonder if he realizes how much he already has?
We began the subspecialist labyrinth in Feb. with our referral to GI here, the above passage from this great artcle written about FPIES from a gastroenterologist says exactly our course. Shuffled through GI, an endoscopy with biopsy's, to the allergist and elemental diet with elimination of foods, reintroductions and little man stayed sick.... "no simple solution" doesn't begin to describe the path we've been on for the past 8mo. through the subspeciality labyrinth looking for support for management of this chronic illness.
Today, we hopefully took another turn closer to getting us out of this labyrinth, or at least show us there IS hope and choices and options for treatment, and support to navigate through it...
This gastroenterologist is associated with another (larger) Children's hosptial....so here is one option- we have another option for where little man would be hospitalized should he ever need this again, or for a food challenge (not trial, a challenge of an already known trigger food). This hospital is not in our home, but an hour and half away- which is not ideal but more realistic than half way across the country that it would take for us to return to CHOP (no matter how much we would rather just go there).
The GI started the appointment by explaining how he had read through little man's chart, which is always good. He asked how he could be of help -- being that we've already consulted with allergists and another GI. Management of his FPIES....specifically support is where we need help. He wanted to know his story- when we first started noticing symptoms, when we got help, when we went to Philadelphia....wait, you physically went all the way out to PA? We explained how he seemed familiar but then not-so-familiar milk protein intolerance, but was he reacting to more in my diet? from almost birth and how his reactions to Good Start formula seemed to wake up a colic, then we moved to rice and other solids to try and get a better handle on what we thought was reflux or hunger, or what? Soy formula last fall exacerbated a reflux, and colic. He wanted to know when he had his scope and when we started the elemental formula's. And what the first scope showed and the second, and how long on the elemental at the time of the 2nd scope? And what is he like now? What diet is he on, what does he tolerate. What about this tapioca reaction, that seems out of the typical response? Lots of good questions to get a good understanding of where we have come,what we have tried and where we are going. He was thorough and listening. He said key things like "I certainly don't argue with the parents"....."if they see something, then that is what it is- I don't live in your home so if you tell me something is wrong, I'm not going to deny it".
What did he think of him reacting to the elemental formula? He has never heard of it either....but he listened while we explained how we came to that conclusion and how we didnt' find a baseline until we finally moved away from any and all sources of corn. He didn't dwell on this, instead saying if our Dietitian is following closely and our Pediatrician- than he sees no reason why Little Man can't be on a homemade formula....if we've worked it out for adequate calories, protein, fats and carbohydrates...
We moved on to discuss his anemia. At this point, his concerns would be his protein intakes (getting better iron-rich sources of protein in his diet or formula) and treating his anemia. He wanted to know why we had not done an IV iron transfusion since he does this all the time for his Crohn's patients- and they feel so much better after having it done. He would be in the hospital and the iron would be transfused in him via IV. He fully agreed that he has a risk of reacting to a blood transfusion and agreed it wouldn't be his first choice for little man.
Pause for a moment with me....can you just imagine what it feels like to be in a room of a subspecialist who is acknowledging your son's illness, listening to your concerns and giving you real options for treatments of the complexity of it? And giving you the support that he would oversee this at the Children's hosptial he works with if this needs to be done.
This GI goes on to explain GI's are not typically the main doctors on an FPIES team, that you don't necessarily need the GI outside of needs for scopes. There is little to test for and this can further frustrate a GI doctor who typically operate on diagnostic tests and criteria they can measure. Remember, he is one- so he knows. The good part about this GI, his good friend is the very Allergist we saw last month (Allergist #3 who confirms Allergist #2 diagnosis of FPIES). He even went on to explain how he learned about FPIES.....everyone has to start somewhere....
A mom whose child did not tolerate soy and it was severe reactions to soy, was looking for help- looking to be heard. This doctor thought he had her simple solution- avoid soy. But the mom was noticing pain and other symptoms with introductions of some other foods and did not know how to proceed, for fear of the soy reaction returning. So she visited his waiting room everytime she introduced a new food. Finally, he said they could challenge soy- since she was passing so many other foods. He admitted her to the ER for monitoring, and fed the child soy. A few hours go by and nothing happens. So, he dismisses her- she goes to the parking lot and waits (she knows her child will be having this reaction soon). Sure enough, the "vomiting her brains out" begins and mom brings her back into the ER. The GI doctor was perplexed, called his allergist buddy and asked him if he knew what was going on, he replied...she has FPIES, haven't you heard of this? He hadn't before, now he did.....
This mom's actions and persistance and advocacy for her daughter has made an excellent and helpful, FPIES friendly GI for so many other moms to follow her....I am grateful to her. And I hope her daughter is now outgrown her FPIES and doing well. Maybe someday I can connect with her (goodness knows, I sure have "met" a good share of FPIES mommy's already!).
He continued to take his time with us, discussing our concerns and how he could be of help...I wonder if he realizes how much he already has?
Sunday, October 24, 2010
Just a mom wanting to be heard....
Just a Mom wanting to be heard
Sharing this website again. A good resource for Rare Disease support. Just a mom wanting to be heard, that has been me for months. To see there are so many other mom's experiencing similar things (with other illnesses) is disheartening and encouraging at the same time. Encouraging that I am not alone, but disheartening that others' are not finding the right avenues to navigate with doctors to hear the cries of a mom for her child.
I do tire of the "fight"....I wish it didn't have to be such a fight to just have help for a child with an illness- even if rare and little understood. I struggle with the "why does it have to be this way"? I just don't understand why someone can't hear me, what I am not saying- what am I portraying wrong? Is my patience being perceived as my son being healthy and not really needing the care? I know it is a rare illness and a clinical diagnosis and I have tried to be patient. But the fact that little man's illness becomes more complex is driving me to 'push' more - not only for him but for his brothers....who all deserve some normalcy in their lives.
Normalcy that can come, despite having to cope with a chronic illness. Normalcy I can provide, coping I am doing....but everything I could do better and with a less heavy heart if there was more support regarding his unique illness and needs surrounding the complexity of it. But my mind does not turn off....always planning next steps, always worried about next steps, always wondering if he will get more and more sick if we don't continue to find out the right things to do to help him. Always researching of what those right things might be. Research more and more about allergies, about digestion, about nutrition, about food families and carbohydrate intolerance's, and now also about how to get a toddler to put food in his mouth when he has not had food for 8mo. and textures and tastes are becoming foreign. And then when he does put it in his mouth, his stomach cramps he associates the eating with pain....and maybe he trusts me a little less.
Tomorrow, we have hope. We see a new GI doctor that has managed a few FPIES cases over the past few years.....although likely none as complex as little man since he works in conjunction with Allergist #3 and that was his comment when reviewing little man's history. We will hold on to to hope that he can provide us with some support for continued management of this illness. The missing pieces in the management of this illness involves just a mom wanting to be heard....
Sharing this website again. A good resource for Rare Disease support. Just a mom wanting to be heard, that has been me for months. To see there are so many other mom's experiencing similar things (with other illnesses) is disheartening and encouraging at the same time. Encouraging that I am not alone, but disheartening that others' are not finding the right avenues to navigate with doctors to hear the cries of a mom for her child.
I do tire of the "fight"....I wish it didn't have to be such a fight to just have help for a child with an illness- even if rare and little understood. I struggle with the "why does it have to be this way"? I just don't understand why someone can't hear me, what I am not saying- what am I portraying wrong? Is my patience being perceived as my son being healthy and not really needing the care? I know it is a rare illness and a clinical diagnosis and I have tried to be patient. But the fact that little man's illness becomes more complex is driving me to 'push' more - not only for him but for his brothers....who all deserve some normalcy in their lives.
Normalcy that can come, despite having to cope with a chronic illness. Normalcy I can provide, coping I am doing....but everything I could do better and with a less heavy heart if there was more support regarding his unique illness and needs surrounding the complexity of it. But my mind does not turn off....always planning next steps, always worried about next steps, always wondering if he will get more and more sick if we don't continue to find out the right things to do to help him. Always researching of what those right things might be. Research more and more about allergies, about digestion, about nutrition, about food families and carbohydrate intolerance's, and now also about how to get a toddler to put food in his mouth when he has not had food for 8mo. and textures and tastes are becoming foreign. And then when he does put it in his mouth, his stomach cramps he associates the eating with pain....and maybe he trusts me a little less.
Tomorrow, we have hope. We see a new GI doctor that has managed a few FPIES cases over the past few years.....although likely none as complex as little man since he works in conjunction with Allergist #3 and that was his comment when reviewing little man's history. We will hold on to to hope that he can provide us with some support for continued management of this illness. The missing pieces in the management of this illness involves just a mom wanting to be heard....
Saturday, October 23, 2010
Forgiveness....
http://tombolo.mn/2010/09/forgiveness/
Maybe because I am simply tired. Maybe because I have so much on my mind for new posts to share but too much to put down in words. Maybe because I don't have any better way to say this message than how this writer says it here...I will simply share this post today. And also connect the reader to an excellent blog for support for families with children of rare, chronic diseases. I find inspiration in others' journey's inspire me.....
Maybe because I am simply tired. Maybe because I have so much on my mind for new posts to share but too much to put down in words. Maybe because I don't have any better way to say this message than how this writer says it here...I will simply share this post today. And also connect the reader to an excellent blog for support for families with children of rare, chronic diseases. I find inspiration in others' journey's inspire me.....
But I've never heard of a child reacting to an elemental formula....
First visit with Allergist #4 was yesterday, it went well and we now have an allergist on our team at home, this will help manage his illness from day-to-day.
Allergist #1 was sure FPIES was not what was ravaging our son's body because he had not ever experienced full shock- even though the research shows that "only" 20% of kids do go into shock. Although, she also admitted that she has only diagnosed one case in her career, and that case is quite severe. I have actually since "met" this mom (online) and yes- her daughter's case is quite severe in her reactions; but otherwise their FPIES course are similar. So, on to a 2nd opinion. I have to say here, that it is funny to me that doctors are surprised when you ask for, or seek out a 2nd opinion. A good doctor would encourage it...would admit their humanity and that they simply can not know everything; some other doctors are challenged by it...what did they miss? I respect the doctor who admits their humanity, that admits they don't know everything but are ready and willing to learn. With their training, experience and expertise; they can catch up fast on something new. I caught up fast- because I live this day in and day out....I am gaining more experience than any study or research article could ever quantify.
Allergist #2 had more experience with this condition,and conditions similar to it; and was able to recognize our son's FPIES immediately by symptoms presented in his history. He was also able to recognize a likely corn trigger intolerance....because of his experience. "There is a small percentage of kids who react to even the elemental formula's and it is unfortunate because it makes it very difficult"....I can attest to that!
Allergist #3- confirms the FPIES once again and gives us a great empowering statement for this difficult clinical diagnosis. "He has FPIES, this has been confirmed by two allergist, here is some information if you would like to learn more"..... So, on to Allergist #4....and back to the clinic we started at- in our home.
Allergist #4 wants to be part of our "team". I've spoken before about how FPIES is best managed by a team- GI, Allergy, Nutrition,Pediatrician, parent (a good social worker would help too- and I'm working on that). I am encouraged that he wants to be a part of the team, wants to be a support for us and a resource of our pediatrician to help us manage this chronic illness that has become complex for little man.
A struggle we still have is the fact that we no longer have little man on an elemental formula, and will not be putting him back on it; instead we have him on a formula that I make. It is adequate in calories, carbohydrates, protein, fats, and macro nutrients but it is lacking in some micro nutrients....nutrients that should be filled in by a diet. But, we have yet to find a diet little man can tolerate in large amounts to contribute to his nutrition. The "easy" answer to the doctors is: put him back on the elemental formula....because after all, "I've never heard of a child reacting to an elemental formula".
I am in nutrition- a dietetic technician, I am Registered- which means I must maintain a certain amount of continuing education yearly. I also am practicing- which means I have a job, a job where I gain more knowledge from my experience. I attend seminars on GI and nutrition and allergies. I have special interest in GI, allergies, and pediatrics. I had never heard of FPIES, and I certainly would not have suspected it to be such a severe and sensitive condition.....but that doesn't mean it didn't exist. It meant simply that I had something to learn.
Many will say that they have never heard of infants being allergic to breastmilk, and yet many infants are....for multitudes of reasons, some still unknown. If a baby can be allergic, or sensitive, or reacting, or not thriving on breastmilk-- that is made from God....Why is it such a stretch that an infant can be allergic to something made by man? There are many additives in formula. The elemental are designed so that the proteins are broken down to single amino acid (something otherwise the body has to do). So, instead the body does not have to break it down- giving it little, if anything, to react to. It simply absorbs it, providing the nutrition the body needs. But, the formula doesn't just contain amino acids. It contains fats and carbohydrates (in the form of oils and sugars). My little man was reacting to the sugars - he has a sugar intolerance but it was more than that, he also has a corn trigger. The corn syrup solids are strained down to remove the proteins but there is chances for trace proteins to remain. FPIES triggers are highly sensitive and some kids can, and do react, to trace proteins....it is why my little man could not thrive on my breastmilk -- reacting to trace proteins.
Everyone following me understands this, right? It makes perfect sense to me, I am living it - I have a perspective on it that I cant' seem to illustrate. How do I get his doctors to understand this? The same doctors that not requested I stop breastfeeding, but insist that I stop breastfeeding as it was clear he was reacting to my milk- despite my giving up all sources of dairy, soy, and gluten. It wasn't enough, he was still reacting to something. I knew that, I knew I had to stop nursing him- I knew something in my diet was making him stay sick; so either drastic measures needed to be taken or I could switch him to an elemental formula. He was so sick, we had to do something quickly. He improved some on the elemental formulas- it helped some but again, just like when I gave up some of his triggers for breastfeeding him and saw some relief - it wasn't enough and he was still reacting to something. In my diet, it was rice and corn, and maybe other things we have not yet identified. In the formula- it was the corn and maybe even the soy oil.
I had never heard of FPIES or reacting to everything in breastmilk or reacting to elemental formula's either.... but I have now.
Allergist #1 was sure FPIES was not what was ravaging our son's body because he had not ever experienced full shock- even though the research shows that "only" 20% of kids do go into shock. Although, she also admitted that she has only diagnosed one case in her career, and that case is quite severe. I have actually since "met" this mom (online) and yes- her daughter's case is quite severe in her reactions; but otherwise their FPIES course are similar. So, on to a 2nd opinion. I have to say here, that it is funny to me that doctors are surprised when you ask for, or seek out a 2nd opinion. A good doctor would encourage it...would admit their humanity and that they simply can not know everything; some other doctors are challenged by it...what did they miss? I respect the doctor who admits their humanity, that admits they don't know everything but are ready and willing to learn. With their training, experience and expertise; they can catch up fast on something new. I caught up fast- because I live this day in and day out....I am gaining more experience than any study or research article could ever quantify.
Allergist #2 had more experience with this condition,and conditions similar to it; and was able to recognize our son's FPIES immediately by symptoms presented in his history. He was also able to recognize a likely corn trigger intolerance....because of his experience. "There is a small percentage of kids who react to even the elemental formula's and it is unfortunate because it makes it very difficult"....I can attest to that!
Allergist #3- confirms the FPIES once again and gives us a great empowering statement for this difficult clinical diagnosis. "He has FPIES, this has been confirmed by two allergist, here is some information if you would like to learn more"..... So, on to Allergist #4....and back to the clinic we started at- in our home.
Allergist #4 wants to be part of our "team". I've spoken before about how FPIES is best managed by a team- GI, Allergy, Nutrition,Pediatrician, parent (a good social worker would help too- and I'm working on that). I am encouraged that he wants to be a part of the team, wants to be a support for us and a resource of our pediatrician to help us manage this chronic illness that has become complex for little man.
A struggle we still have is the fact that we no longer have little man on an elemental formula, and will not be putting him back on it; instead we have him on a formula that I make. It is adequate in calories, carbohydrates, protein, fats, and macro nutrients but it is lacking in some micro nutrients....nutrients that should be filled in by a diet. But, we have yet to find a diet little man can tolerate in large amounts to contribute to his nutrition. The "easy" answer to the doctors is: put him back on the elemental formula....because after all, "I've never heard of a child reacting to an elemental formula".
I am in nutrition- a dietetic technician, I am Registered- which means I must maintain a certain amount of continuing education yearly. I also am practicing- which means I have a job, a job where I gain more knowledge from my experience. I attend seminars on GI and nutrition and allergies. I have special interest in GI, allergies, and pediatrics. I had never heard of FPIES, and I certainly would not have suspected it to be such a severe and sensitive condition.....but that doesn't mean it didn't exist. It meant simply that I had something to learn.
Many will say that they have never heard of infants being allergic to breastmilk, and yet many infants are....for multitudes of reasons, some still unknown. If a baby can be allergic, or sensitive, or reacting, or not thriving on breastmilk-- that is made from God....Why is it such a stretch that an infant can be allergic to something made by man? There are many additives in formula. The elemental are designed so that the proteins are broken down to single amino acid (something otherwise the body has to do). So, instead the body does not have to break it down- giving it little, if anything, to react to. It simply absorbs it, providing the nutrition the body needs. But, the formula doesn't just contain amino acids. It contains fats and carbohydrates (in the form of oils and sugars). My little man was reacting to the sugars - he has a sugar intolerance but it was more than that, he also has a corn trigger. The corn syrup solids are strained down to remove the proteins but there is chances for trace proteins to remain. FPIES triggers are highly sensitive and some kids can, and do react, to trace proteins....it is why my little man could not thrive on my breastmilk -- reacting to trace proteins.
Everyone following me understands this, right? It makes perfect sense to me, I am living it - I have a perspective on it that I cant' seem to illustrate. How do I get his doctors to understand this? The same doctors that not requested I stop breastfeeding, but insist that I stop breastfeeding as it was clear he was reacting to my milk- despite my giving up all sources of dairy, soy, and gluten. It wasn't enough, he was still reacting to something. I knew that, I knew I had to stop nursing him- I knew something in my diet was making him stay sick; so either drastic measures needed to be taken or I could switch him to an elemental formula. He was so sick, we had to do something quickly. He improved some on the elemental formulas- it helped some but again, just like when I gave up some of his triggers for breastfeeding him and saw some relief - it wasn't enough and he was still reacting to something. In my diet, it was rice and corn, and maybe other things we have not yet identified. In the formula- it was the corn and maybe even the soy oil.
I had never heard of FPIES or reacting to everything in breastmilk or reacting to elemental formula's either.... but I have now.
Friday, October 22, 2010
Digestion
I am brushing up on my digestion health knowledge, once again. It is always good to take a re-look at things when you have some new "eyes" to look at things with. I now see everything with "FPIES eyes". This illustration is hanging in one of my offices at work, we like it because it is in color, and it shows such a simple- yet informative- illustration of nutrients and the workings of the GI tract (in particular if you have pieces of this missing, or in my son's case- chronically and acutely inflamed. I was able to find it online, so anyone can take a peek at it too: Digestion and absorption of nutrients
It was last Dec., after 4mo of trying to figure out on my own what was going on with his little body, trying to control things with a milk protein intolerance consideration (new foods should have worked, as long as we avoided dairy)....but they weren't working. Soy formula was failing, building up a resistance and causing it's own host of new concerning symptoms. The biggest thing that I was able to finally connect that his body was showing a sensitivity build up to soy was a croup-y cough. Others have talked about this similar type of cough with food reactions (often soy is a culprit)- I wonder if it is actually from the reflux? Could be....warrants further investigation at some point. But for now, either way- his body was not tolerating the small amounts we were doing. By mid December, all I could think was- lets just get through the holidays and then I am going to have to bring him in to his pediatrician because I simply can not grasp a handle on this by myself anymore. I already knew that outside of frank vomiting and bloody stools- little is recognized about delayed food intolerance's in the medical community. From a dietetics standpoint, we see things differently but we also remain cautious as to not encourage someone to unnecessarily over-restrict the diet....especially the diet of a growing child. Restricting my son's diet has never been my intention....adding to it has. But FPIES takes that away, in a cruel way. Food is not just food anymore. Allergies take on a whole new meaning.
Ok, back to December. Our pediatrician agreed little man was likely building up an intolerance to soy, as many dairy intolerant infants do, and to try him on a 100% no milk,no soy diet (breastfeeding for me and his foods as well), keep a journal, and try Nutramagin, Pregistimal or Alimentum. I chose Nutramagin. Only to have him projectile vomit all over our kitchen, multiple times that day. We even tried it a few more times- just to be sure....each time being more and more obvious and concerning. Back to the pediatrician and labs were checked for allergies, and gluten sensitivity, CBC, and iron, and 'did I want to check anything else'? Yes, I'm curious to what his Vit.D levels are. He was a breastfed baby and research is showing there is higher incidence for some Vit.D deficiency's in breastfed babies, we're getting labs- lets check that too. No one, not even me anticipated the results we got. His level was 9ng/ml, with normal being 24-80ng/ml. Diagnosis: profoundly vitamin D deficient. We immediately started a supplement to restore these levels. But my concern remained....how did his levels get so low? Was my milk this deficient? I had my levels checked just to be sure I wasn't in trouble too....no, my levels were within normal limits. But, research has shown that even if mom is not deficient- breastmilk can be (and often is). But really? This deficient? How normal is this? I already knew by his actions of gas and stomach discomfort that he was having digestion issues, maybe inflammation - my instincts were telling me this....that he had gut inflammation in his small intestine and dysbiosis in his colon. The gut inflammation was causing a "leaky gut" and causing his body to be sensitive to dietary proteins. These were my instincts- I had never even heard of FPIES. Until I printed off an article from EMedicine about Protein Intolerance, there was a brief mention of it there. I highlighted it in my reading, along with milk protein intolerance, multiple protein intolerance, Eosinophiliac disorders, Celiac, protein enteropathy. My research began with that Protein Intolerance article. My instincts were confirmed by his labs showing a low iron and low Vit.D, as well as a low IgA (mucosa lining of GI tract). Now what to do with this information? What do we do next?
It was last Dec., after 4mo of trying to figure out on my own what was going on with his little body, trying to control things with a milk protein intolerance consideration (new foods should have worked, as long as we avoided dairy)....but they weren't working. Soy formula was failing, building up a resistance and causing it's own host of new concerning symptoms. The biggest thing that I was able to finally connect that his body was showing a sensitivity build up to soy was a croup-y cough. Others have talked about this similar type of cough with food reactions (often soy is a culprit)- I wonder if it is actually from the reflux? Could be....warrants further investigation at some point. But for now, either way- his body was not tolerating the small amounts we were doing. By mid December, all I could think was- lets just get through the holidays and then I am going to have to bring him in to his pediatrician because I simply can not grasp a handle on this by myself anymore. I already knew that outside of frank vomiting and bloody stools- little is recognized about delayed food intolerance's in the medical community. From a dietetics standpoint, we see things differently but we also remain cautious as to not encourage someone to unnecessarily over-restrict the diet....especially the diet of a growing child. Restricting my son's diet has never been my intention....adding to it has. But FPIES takes that away, in a cruel way. Food is not just food anymore. Allergies take on a whole new meaning.
Ok, back to December. Our pediatrician agreed little man was likely building up an intolerance to soy, as many dairy intolerant infants do, and to try him on a 100% no milk,no soy diet (breastfeeding for me and his foods as well), keep a journal, and try Nutramagin, Pregistimal or Alimentum. I chose Nutramagin. Only to have him projectile vomit all over our kitchen, multiple times that day. We even tried it a few more times- just to be sure....each time being more and more obvious and concerning. Back to the pediatrician and labs were checked for allergies, and gluten sensitivity, CBC, and iron, and 'did I want to check anything else'? Yes, I'm curious to what his Vit.D levels are. He was a breastfed baby and research is showing there is higher incidence for some Vit.D deficiency's in breastfed babies, we're getting labs- lets check that too. No one, not even me anticipated the results we got. His level was 9ng/ml, with normal being 24-80ng/ml. Diagnosis: profoundly vitamin D deficient. We immediately started a supplement to restore these levels. But my concern remained....how did his levels get so low? Was my milk this deficient? I had my levels checked just to be sure I wasn't in trouble too....no, my levels were within normal limits. But, research has shown that even if mom is not deficient- breastmilk can be (and often is). But really? This deficient? How normal is this? I already knew by his actions of gas and stomach discomfort that he was having digestion issues, maybe inflammation - my instincts were telling me this....that he had gut inflammation in his small intestine and dysbiosis in his colon. The gut inflammation was causing a "leaky gut" and causing his body to be sensitive to dietary proteins. These were my instincts- I had never even heard of FPIES. Until I printed off an article from EMedicine about Protein Intolerance, there was a brief mention of it there. I highlighted it in my reading, along with milk protein intolerance, multiple protein intolerance, Eosinophiliac disorders, Celiac, protein enteropathy. My research began with that Protein Intolerance article. My instincts were confirmed by his labs showing a low iron and low Vit.D, as well as a low IgA (mucosa lining of GI tract). Now what to do with this information? What do we do next?
Thursday, October 21, 2010
The Reality....
There is a reality to FPIES, to our FPIES, that I often do my best to hide. Why do I do that? Maybe because I am optimistic, maybe because I try to always stay positive, and patient, maybe because I think it is pointless to blame someone for what my son was born with, maybe because I know life is too short to waste on regrets and 'what ifs', maybe it's my Faith. But maybe it will help to just once discuss the bits and pieces of this reality - just once let some out in the light. Of course, those who know me well enough know the reality well but many don't. I have a very close friend that has been by my side every step of the way through this, every.single.step. And she said to me one day that she did not even know how bad it really gets- had barely ever even heard Little Man have one of his agitation cry fits (we mostly were just talking on the phone at that point, being too busy for much else), and certainly had never witnessed one of his reactions. My sister, A., lived with us for awhile and before she witnessed them- she could not have imagined it either. She became very attuned to them and would be at my side immediately..."what do you need me to do?"
The reality is that little man has been sick for most of his life. He had FPIES ravaging his body before we ever even heard of such a terrible thing. Maybe if I had recognized it sooner, maybe if I had ever heard of FPIES, maybe if the doctors had ever heard of FPIES -- if it had been in the differential diagnosis for the pediatrician in the early stages, or the GI or Allergist when his weight fell from 80th% to 40th% down to the 11th% and required a hospitalization to get his nutrition back on track. Unfortunately that meant taking a new track that only continued to worsen his nutrition and cascade his illness -- being that no one knew about FPIES and it's extreme sensitivity to trace proteins....even trace proteins in breastmilk and elemental formula's. It is a bizarre illness, but it is real. The reality is FPIES allergy's are severe and sensitive and these children do react to trace proteins - in breastmilk, in medications, in corn syrup solids and soy oils in formula.
The reality is that all food is "poison" in our house. The reality is that there has way too much crying and not enough happy moments of calm and routine that kids can thrive on....that I strive to provide for my children. The reality remains that meals in our house are more of just the "hassle" of 'what's for dinner'- it is trying to cook with a toddler seeing and smelling the food he can't have, the reality of how many times I would normally use a cracker or a fruit cup, a cheese stick as a distraction for my other boys, while I cooked dinner. For little man- I let him dig through cupboards.... The reality that eating a meal as a family is more of a rare, and rushed occurrence, than the normal for us anymore; and more often than not- one of us takes Little Man out of the room and distracts him downstairs. The reality is that I do not even have a bath soap that is safe to wash him with. That he is up at all different hours of the night - and I have no idea why, should I be worried? Is he having a reaction to something? This is where it all started at just 10days old when 2am was his 2hr.-wide-awake time....he's doing it again and besides the fact that I am so extremely over tired, I'm worried about what it means.
The reality is that his iron status has always been low, his Vit.D was profoundly deficient the first time we checked labs on him when he was 6mo. old....no one had any idea why....I had my suspicions- instincts that were right on about his gut inflammation. His chronic inflammation kept him from absorbing good nutrients, even while breastfed. His beginning of blood in stools following corn fail dropped it even more, his vegetarian diet of hemp milk had difficulty replenishing his already low stores, and then more blood in stools. The reality is that because I will not allow him to have the elemental formula that continued to make him sick for 5mo.; I am now getting blamed for his poor nutrition labs, his low iron, his weight gains not being more....despite the fact that I have been looking for help for his FPIES and to stabilize his illness for months. The reality is I don't want to complain about things I can not change, but I do want to change the things I can.
The reality is that his anemia is scaring me. That it is just one more thing in his complex illness to worry about, to wonder, and want to know, what is going on inside his little body. That, when he starts to get overtired, or his heart starts to race - I worry.
The reality that when he starts to cry and I don't know why, I worry and I begin to panic- what did he eat, what is he reacting to, now long will this last, will it get worse, how is this affecting his brothers well-being? That when he won't eat enough of his formula to gain weight- I begin to panic. That when he won't even let a new food touch his lips, I worry about how he is going to get a well rounded diet when he won't eat, much less try, the new foods.
The reality is I want to trust my instincts, and knock out some food trials....of things like eggs, almonds, white potatoes, coconut milk, avocado, banana, beef, lamb, quinoa, mango, peaches, apricots, carrots, squash. But if we're already getting blamed for his illness and his nutrition state because of it....if he gets sick from these food trials (that of course we would do in a very slow trials)- how much more blame can we carry? The reality is, I feel trapped. Between a rock and a hard place -- this whole journey has kept me between a rock and a hard place.
The reality is - I just want him to be the best he can be with this chronic illness. I want him to have what every child deserves- a good quality of life. And in that, I want that for my other boys as well....if little man's illness remains so high needs- it is difficult to give them that also. My focus is my family....Little man has required much of my time and energy over the past year. The reality is, there isn't anything, not.one.thing I wouldn't do for him. This is (a little bit of) the reality with a FPIES child, in our family.
The reality is that little man has been sick for most of his life. He had FPIES ravaging his body before we ever even heard of such a terrible thing. Maybe if I had recognized it sooner, maybe if I had ever heard of FPIES, maybe if the doctors had ever heard of FPIES -- if it had been in the differential diagnosis for the pediatrician in the early stages, or the GI or Allergist when his weight fell from 80th% to 40th% down to the 11th% and required a hospitalization to get his nutrition back on track. Unfortunately that meant taking a new track that only continued to worsen his nutrition and cascade his illness -- being that no one knew about FPIES and it's extreme sensitivity to trace proteins....even trace proteins in breastmilk and elemental formula's. It is a bizarre illness, but it is real. The reality is FPIES allergy's are severe and sensitive and these children do react to trace proteins - in breastmilk, in medications, in corn syrup solids and soy oils in formula.
The reality is that all food is "poison" in our house. The reality is that there has way too much crying and not enough happy moments of calm and routine that kids can thrive on....that I strive to provide for my children. The reality remains that meals in our house are more of just the "hassle" of 'what's for dinner'- it is trying to cook with a toddler seeing and smelling the food he can't have, the reality of how many times I would normally use a cracker or a fruit cup, a cheese stick as a distraction for my other boys, while I cooked dinner. For little man- I let him dig through cupboards.... The reality that eating a meal as a family is more of a rare, and rushed occurrence, than the normal for us anymore; and more often than not- one of us takes Little Man out of the room and distracts him downstairs. The reality is that I do not even have a bath soap that is safe to wash him with. That he is up at all different hours of the night - and I have no idea why, should I be worried? Is he having a reaction to something? This is where it all started at just 10days old when 2am was his 2hr.-wide-awake time....he's doing it again and besides the fact that I am so extremely over tired, I'm worried about what it means.
The reality is that his iron status has always been low, his Vit.D was profoundly deficient the first time we checked labs on him when he was 6mo. old....no one had any idea why....I had my suspicions- instincts that were right on about his gut inflammation. His chronic inflammation kept him from absorbing good nutrients, even while breastfed. His beginning of blood in stools following corn fail dropped it even more, his vegetarian diet of hemp milk had difficulty replenishing his already low stores, and then more blood in stools. The reality is that because I will not allow him to have the elemental formula that continued to make him sick for 5mo.; I am now getting blamed for his poor nutrition labs, his low iron, his weight gains not being more....despite the fact that I have been looking for help for his FPIES and to stabilize his illness for months. The reality is I don't want to complain about things I can not change, but I do want to change the things I can.
The reality is that his anemia is scaring me. That it is just one more thing in his complex illness to worry about, to wonder, and want to know, what is going on inside his little body. That, when he starts to get overtired, or his heart starts to race - I worry.
The reality that when he starts to cry and I don't know why, I worry and I begin to panic- what did he eat, what is he reacting to, now long will this last, will it get worse, how is this affecting his brothers well-being? That when he won't eat enough of his formula to gain weight- I begin to panic. That when he won't even let a new food touch his lips, I worry about how he is going to get a well rounded diet when he won't eat, much less try, the new foods.
The reality is I want to trust my instincts, and knock out some food trials....of things like eggs, almonds, white potatoes, coconut milk, avocado, banana, beef, lamb, quinoa, mango, peaches, apricots, carrots, squash. But if we're already getting blamed for his illness and his nutrition state because of it....if he gets sick from these food trials (that of course we would do in a very slow trials)- how much more blame can we carry? The reality is, I feel trapped. Between a rock and a hard place -- this whole journey has kept me between a rock and a hard place.
The reality is - I just want him to be the best he can be with this chronic illness. I want him to have what every child deserves- a good quality of life. And in that, I want that for my other boys as well....if little man's illness remains so high needs- it is difficult to give them that also. My focus is my family....Little man has required much of my time and energy over the past year. The reality is, there isn't anything, not.one.thing I wouldn't do for him. This is (a little bit of) the reality with a FPIES child, in our family.
Wednesday, October 20, 2010
Moving on....
We are considering millet to be safe/pass. He doesn't love the porridge and I do not think he can tolerate much more then 5tsp of it without some stomach discomfort in general but I am putting it on the list of safe foods to rotate around (once we have enough safe foods to do this!). I will keep offering it to him. For 2 days this week, I gave him millet porridge and plum mix- he took coaxing (and reading stories and making animal noises and a cheering squad) but he ate 10 baby teaspoonfuls each day. The first day, he did great- no issues whatsoever. The second, he was starting to show some discomfort. This seems to be a trend we've noticed (these food trials having lots of stop-start because of our schedules and other things that arise). The start-stop pattern has put together some clues for him (I think). From what I can tell, he does good the first day of the food, by day 2 - he showing some signs of tummy aches and by day 3 we have to slow way down or stop (or he just refuses) because his stomach aches are too much. I think he may do well with a rotation diet.only right now we have nothing to rotate! But plums have had more pain than millet, millet wasn't pain- just some minimal discomfort every now and then. Plums are a more obvious pain...although we did it so slowly and in such small amounts - I think we controlled it ok for him. So, plums will be put to the side for now. They will be a "see you later" food....there is no reason for such small amounts of food to cause so much discomfort. Fruits will be a challenge with him (all carbohydrates will be) but fruits will be an extra challenge. To find the ones that do not cause his belly pain with the entire digestion process, and diarrhea.
So, on to spinach. I bought some today- steamed it and pureed it. We plan to start tomorrow. I have no idea what to expect.
I also got Probiotics today - ordered hypoallergenic ones online. I am anxious to see how he would do on these but it will have to be a sort of trial in itself. So, I have to wait a bit for that. When we need a break, between one of the next food trials.
Today, was a break. Today he had a good day. Lots of playing on his own, little whining, sleeping ok, eating well. Lets hope it continues through the spinach trial!
So, on to spinach. I bought some today- steamed it and pureed it. We plan to start tomorrow. I have no idea what to expect.
I also got Probiotics today - ordered hypoallergenic ones online. I am anxious to see how he would do on these but it will have to be a sort of trial in itself. So, I have to wait a bit for that. When we need a break, between one of the next food trials.
Today, was a break. Today he had a good day. Lots of playing on his own, little whining, sleeping ok, eating well. Lets hope it continues through the spinach trial!
Monday, October 18, 2010
Driving force....
If you are doing everything you know to do to nurture your child, and one of those things (feeding) is actually contributing to their pain/distress and illness. Living through so many months of not knowing what was wrong with your baby, of thinking it was surely something you were doing wrong, feeding him foods that he would later throw up, and that would always cause him so much pain is traumatic. Being overwhelmed with feelings of powerless and hopelessness. How can this not be anxiety provoking?
If your child has a syndrome that not many understand, and instead of being acknowledged as a syndrome of confusing symptoms it is dismissed because medicine has no answers....or worse, the parents are made to feel that it is something they are doing wrong and not something that medicine is missing, because it is easier for medicine – that functions on concrete- to be able to say the anxiety of the parents (mom) is more of the issue than the child’s actual symptoms of pain and discomfort. What affect would that have on you and your overall well being? How can this not be anxiety provoking?
FPIES is an anxiety provoking diagnosis. It is one of the things that make it most difficult from day to day.
The anxiety is fueled by so many things - it becomes a sort of PTSD kind of being. Post traumatic stress because of a pain filled baby that you can only watch and do nothing for while he cried and cried and then violently vomited the contents of his stomach, and many sleepless nights of worry and a baby in pain. Post traumatic stress from hospital stays where you were actually accused of causing this pain and distress, and poor nutritional state to this little beautiful boy -- when you were only doing everything in your human (and sometimes superhuman) strength to help him.
Food trials always bring this anxiety to the surface in me. I try to push it back down, I don't like to feel anxious and I don't like it to affect me...so I push back. Although I do find, no matter how hard I try, it is there- just lingering around. I have found ways to help with it. Blogging, support groups, learning from and connecting with other mom's going through the same things, caring people who help and provide hope, having our pediatrician follow his progress and developments with me,....It all comes down to the one thing that is best for my anxiety -- to be/feel empowered.
My anxiety has been my driving force. It is not dragging me down, it is driving me forward. I have found studying and researching everything related to my son's FPIES not only therapeutic, but empowering. I also find helping others to be therapeutic. I have been putting together information for an FPIES Resource page for families. While putting together this page, I was approached to join forces of an organization already established to accomplish this very thing. The foundation needs new mom's to "carry the torch" and I have agreed to help be one of those moms. I have had a drive to pull it altogether, to help more family's. To give resources, support and hope to family's facing this frustrating, anxiety provoking diagnosis. Awareness is educating. Education is empowering. Empowering is healing.
Watch for updates on The PIC Foundation!!
If your child has a syndrome that not many understand, and instead of being acknowledged as a syndrome of confusing symptoms it is dismissed because medicine has no answers....or worse, the parents are made to feel that it is something they are doing wrong and not something that medicine is missing, because it is easier for medicine – that functions on concrete- to be able to say the anxiety of the parents (mom) is more of the issue than the child’s actual symptoms of pain and discomfort. What affect would that have on you and your overall well being? How can this not be anxiety provoking?
FPIES is an anxiety provoking diagnosis. It is one of the things that make it most difficult from day to day.
The anxiety is fueled by so many things - it becomes a sort of PTSD kind of being. Post traumatic stress because of a pain filled baby that you can only watch and do nothing for while he cried and cried and then violently vomited the contents of his stomach, and many sleepless nights of worry and a baby in pain. Post traumatic stress from hospital stays where you were actually accused of causing this pain and distress, and poor nutritional state to this little beautiful boy -- when you were only doing everything in your human (and sometimes superhuman) strength to help him.
Food trials always bring this anxiety to the surface in me. I try to push it back down, I don't like to feel anxious and I don't like it to affect me...so I push back. Although I do find, no matter how hard I try, it is there- just lingering around. I have found ways to help with it. Blogging, support groups, learning from and connecting with other mom's going through the same things, caring people who help and provide hope, having our pediatrician follow his progress and developments with me,....It all comes down to the one thing that is best for my anxiety -- to be/feel empowered.
My anxiety has been my driving force. It is not dragging me down, it is driving me forward. I have found studying and researching everything related to my son's FPIES not only therapeutic, but empowering. I also find helping others to be therapeutic. I have been putting together information for an FPIES Resource page for families. While putting together this page, I was approached to join forces of an organization already established to accomplish this very thing. The foundation needs new mom's to "carry the torch" and I have agreed to help be one of those moms. I have had a drive to pull it altogether, to help more family's. To give resources, support and hope to family's facing this frustrating, anxiety provoking diagnosis. Awareness is educating. Education is empowering. Empowering is healing.
Watch for updates on The PIC Foundation!!
Sunday, October 17, 2010
How is Little Man?
I wish I could answer this and know the answer I gave was accurate. But I do not know. His anemia is keeping him laying low most days. We will likely get his levels checked again sometime this week to check on it. I'm not sure if this is what is causing all his random off baseline things we have been seeing, or if it is from food trials - although we see this even if he hasn't had food that day as we are taking it super-super slow with the food trials. We stopped millet- it was looking non-FPIES but may have had some digestion issues but seemed better with the cooked porridge but then he didn't want to eat it. So we stopped, took a few days off and then started his plum trial. Plums are more questionable than millet was! But he likes them better! I want to be able to call them both a pass -so I can put the plums in the millet and flavor it, giving him something fun and tasty to eat that is also adding to his nutrition! I am trying to be patient. Patience is what I hear from the other moms, slow but sure and watching closely. Also "met" a mom with a 5yr.old little boy with FPIES online this weekend; she has great wisdom to share....sharing that using the most liquid/puree form of the food and then working the way up as tolerated -- and slowly! And if there is a digestion issue, than stop the food. FPIES or not, if he can not tolerate it, he can't tolerate it. I agree- no child should have to have so much pain just from eating such small amounts of food. The question is: is it from the food trials? Is it from teething? Is it from the iron? Is it from the anemia? I believe the disturbed sleep is from the iron or the anemia; I think the decreased appetite is from the anemia - he takes an average of 700cal/day- at least 300 less than what he needs to gain weight! Although he expends a lot less energy. We are frequently carrying him around, he plays well on his own but he doesn't run as much as he did a month or so ago. I imagine he is just tired. I don't like seeing him like this but the benefit still does not outweigh the risk for a transfusion, but I will be glad when he beats this and he can feel better and run and play more. We took him in for a weight check, as we do this often throughout his illness. It has been one way to monitor his reactions and how long it takes for him to heal, and if he is eating enough- calorically, or absorbing enough nutrients. The good news is he hasn't lost! Even with 2weeks of eating 300 less calories than his needs; he hasn't gained much but has a tiny bit....and he hasn't lost!
Today, he woke up stuffy and with a low grade fever, remained "clingy" all day and then threw up this afternoon. We have no idea what caused it. It wasn't violent so whatever it was it was only "mild". He felt better after his nap. What is causing all this? How do we proceed when we are barely moving and we are getting all these mysterious signs/symptoms. Can we attribute it all to his anemia? What if he is slowly building towards a reaction? What if he is having blood in stools again? His last positive stool samples, we couldn't even visually see the blood- it was microscopic.
We see GI on Tuesday, an Allergist (this will make #4 for Allergists, #1-no FPIES, #2, absolutely no doubt FPIES, #3- confirms FPIES, #4 - ?). We need this 4th Allergist because he is the one actually in the clinic where the rest of his team is. We only ask that he be open minded, and willing to learn so he can help Little Man.
We will proceed with food trials tomorrow, I think....
Today, he woke up stuffy and with a low grade fever, remained "clingy" all day and then threw up this afternoon. We have no idea what caused it. It wasn't violent so whatever it was it was only "mild". He felt better after his nap. What is causing all this? How do we proceed when we are barely moving and we are getting all these mysterious signs/symptoms. Can we attribute it all to his anemia? What if he is slowly building towards a reaction? What if he is having blood in stools again? His last positive stool samples, we couldn't even visually see the blood- it was microscopic.
We see GI on Tuesday, an Allergist (this will make #4 for Allergists, #1-no FPIES, #2, absolutely no doubt FPIES, #3- confirms FPIES, #4 - ?). We need this 4th Allergist because he is the one actually in the clinic where the rest of his team is. We only ask that he be open minded, and willing to learn so he can help Little Man.
We will proceed with food trials tomorrow, I think....
Saturday, October 16, 2010
The Invitation
I have been connected with an amazing woman's website. It is a website aimed at support for families with rare childhood diseases, here is her website: rare disease support. It is filled with great support and resources for families and caregivers. One of her blogs devoted space to this poem. It spoke to me and I wanted to share it. Inspiration is coping. Emowerment is coping. Paying it foward and helping others is coping. Bloggins is coping, to me....
Oriahmountaindreamer
The Invitation
by Oriah
It doesn’t interest me
what you do for a living.
I want to know
what you ache for
and if you dare to dream
of meeting your heart’s longing.
It doesn’t interest me
how old you are.
I want to know
if you will risk
looking like a fool
for love
for your dream
for the adventure of being alive.
It doesn’t interest me
what planets are
squaring your moon...
I want to know
if you have touched
the centre of your own sorrow
if you have been opened
by life’s betrayals
or have become shrivelled and closed
from fear of further pain.
I want to know
if you can sit with pain
mine or your own
without moving to hide it
or fade it
or fix it.
I want to know
if you can be with joy
mine or your own
if you can dance with wildness
and let the ecstasy fill you
to the tips of your fingers and toes
without cautioning us
to be careful
to be realistic
to remember the limitations
of being human.
It doesn’t interest me
if the story you are telling me
is true.
I want to know if you can
disappoint another
to be true to yourself.
If you can bear
the accusation of betrayal
and not betray your own soul.
If you can be faithless
and therefore trustworthy.
I want to know if you can see Beauty
even when it is not pretty
every day.
And if you can source your own life
from its presence.
I want to know
if you can live with failure
yours and mine
and still stand at the edge of the lake
and shout to the silver of the full moon,
“Yes.”
It doesn’t interest me
to know where you live
or how much money you have.
I want to know if you can get up
after the night of grief and despair
weary and bruised to the bone
and do what needs to be done
to feed the children.
It doesn’t interest me
who you know
or how you came to be here.
I want to know if you will stand
in the centre of the fire
with me
and not shrink back.
It doesn’t interest me
where or what or with whom
you have studied.
I want to know
what sustains you
from the inside
when all else falls away.
I want to know
if you can be alone
with yourself
and if you truly like
the company you keep
in the empty moments.
By Oriah © Mountain Dreaming,
from the book The Invitation
published by HarperONE, San Francisco,
1999 All rights reserved
Oriahmountaindreamer
The Invitation
by Oriah
It doesn’t interest me
what you do for a living.
I want to know
what you ache for
and if you dare to dream
of meeting your heart’s longing.
It doesn’t interest me
how old you are.
I want to know
if you will risk
looking like a fool
for love
for your dream
for the adventure of being alive.
It doesn’t interest me
what planets are
squaring your moon...
I want to know
if you have touched
the centre of your own sorrow
if you have been opened
by life’s betrayals
or have become shrivelled and closed
from fear of further pain.
I want to know
if you can sit with pain
mine or your own
without moving to hide it
or fade it
or fix it.
I want to know
if you can be with joy
mine or your own
if you can dance with wildness
and let the ecstasy fill you
to the tips of your fingers and toes
without cautioning us
to be careful
to be realistic
to remember the limitations
of being human.
It doesn’t interest me
if the story you are telling me
is true.
I want to know if you can
disappoint another
to be true to yourself.
If you can bear
the accusation of betrayal
and not betray your own soul.
If you can be faithless
and therefore trustworthy.
I want to know if you can see Beauty
even when it is not pretty
every day.
And if you can source your own life
from its presence.
I want to know
if you can live with failure
yours and mine
and still stand at the edge of the lake
and shout to the silver of the full moon,
“Yes.”
It doesn’t interest me
to know where you live
or how much money you have.
I want to know if you can get up
after the night of grief and despair
weary and bruised to the bone
and do what needs to be done
to feed the children.
It doesn’t interest me
who you know
or how you came to be here.
I want to know if you will stand
in the centre of the fire
with me
and not shrink back.
It doesn’t interest me
where or what or with whom
you have studied.
I want to know
what sustains you
from the inside
when all else falls away.
I want to know
if you can be alone
with yourself
and if you truly like
the company you keep
in the empty moments.
By Oriah © Mountain Dreaming,
from the book The Invitation
published by HarperONE, San Francisco,
1999 All rights reserved
Thursday, October 14, 2010
Lists...
I'm a list maker. It helps me keep organized. It helps me feel like I've accomplished something in a day, when I'm at home and the whole day is constant interruptions. Multi-tasking, who does this better than a mom? Only thing is, lately I'm more than just mom. Of course I am also a Dietetic Technician part time too but that is something I enjoy too...I enjoy helping people. But I'm not accustomed to having people help me. Patience my 1st son taught me most. Strength is what my 2nd son taught me most. Time for fun and giggles is what my 3rd son taught me most. And Humility is something Little Man has taught me.
These days, my lists are longer than the day. My plate and cup runneth over. I want to just be mom. Don't get me wrong, I am not asking for anyone to take away his FPIES. I just want help putting the pieces of this puzzle together and managing them, so I can be the mom I was born to be -- to little man and to my other boys. The help I want is in his coordinated care of medical professionals that are there when his illness goes out of my scope of knowledge. I am his mom, I will always know what is best for him but I don't always know what to do when he has low hemoglobin, or he is reacting, or his diet is too limited, or his digestion is off balance, or when he has pain that I can't identify or take away....
Researching his allergy and his digestion is top on my mind these days. I have so many things to read and go through, some things I've read before but seeing differently with "FPIES eyes", some things are new and unexplored, some things are "out of the box".
It is clear to me that his digestion is off balance. He doesn't have the proper enzymes to breakdown foods in the small intestine (this confirmed by his dissacharidase deficiency on last biopsy), I suspect he has a low mucosa lining to his gut (this shown by his low IgA levels), his inflammation is chronic, and at last scope- patchy. Improperly digested foods go through his small intestines- where they are attempting to be absorbed but too big and thus causing allergic reactions from his body rejecting it. The food propels through his small intestine to his large intestine (colon) where his lack of good gut flora leave it unable to breakdown and only feed the dysbiosis, this showed by diaper rashes that look "yeasty" with any ingestion's of sugars. I need to correct his imbalances or food trials will continue to go as they have -- uncomfortable and uneasy....
Where do I start? I make a list....
These days, my lists are longer than the day. My plate and cup runneth over. I want to just be mom. Don't get me wrong, I am not asking for anyone to take away his FPIES. I just want help putting the pieces of this puzzle together and managing them, so I can be the mom I was born to be -- to little man and to my other boys. The help I want is in his coordinated care of medical professionals that are there when his illness goes out of my scope of knowledge. I am his mom, I will always know what is best for him but I don't always know what to do when he has low hemoglobin, or he is reacting, or his diet is too limited, or his digestion is off balance, or when he has pain that I can't identify or take away....
Researching his allergy and his digestion is top on my mind these days. I have so many things to read and go through, some things I've read before but seeing differently with "FPIES eyes", some things are new and unexplored, some things are "out of the box".
It is clear to me that his digestion is off balance. He doesn't have the proper enzymes to breakdown foods in the small intestine (this confirmed by his dissacharidase deficiency on last biopsy), I suspect he has a low mucosa lining to his gut (this shown by his low IgA levels), his inflammation is chronic, and at last scope- patchy. Improperly digested foods go through his small intestines- where they are attempting to be absorbed but too big and thus causing allergic reactions from his body rejecting it. The food propels through his small intestine to his large intestine (colon) where his lack of good gut flora leave it unable to breakdown and only feed the dysbiosis, this showed by diaper rashes that look "yeasty" with any ingestion's of sugars. I need to correct his imbalances or food trials will continue to go as they have -- uncomfortable and uneasy....
Where do I start? I make a list....
Wednesday, October 13, 2010
Navigating through these murky waters.....
FPIES is a journey. A journey in very rough waters - and that is on a good day. Always worrying about crumb ingestion, reactions to foods, trialing new foods, ER plans, specialist appointments, hospital stays, doctors recognizing a little known, but very real, diagnosis (and not blaming you for their nutritional state of labs that are off and growth charts that are mountain ranges), coordinating all this care can be overwhelming. I am always on the look out for ways to make it less overwhelming, to have any help I can get to navigate these rough and murky waters. Navigating the journey requires coordination from all team members. A good captain knows his crew and has the tools to delegate the navigation. We have been lost in these murky waters of FPIES without a proper crew and insufficient tools. It is difficult to be at the helm and in the "belly of the boat" at the same time. And yet, that is where we keep finding ourselves- and stretched too thin. Or, as Little Man's daddy so eloquently put it...."you can't rescue people from a burning building and put the fire out at the same time, (by yourself)"....you need to focus your energy at one task at a time; and then refocus to keep things moving. We are constantly having to shift our focus, when we really want to rescue our son....putting out the fire can should be the doctors part of this illness.
Navigating murky waters with the diagnosis and knowing what next steps to take, with the coordinated care team, and now with food trials. We are on day 5 of plums but Little Man isn't feeling well. Day 1 went well, he liked them and he ate them himself; there were a few small concerning symptoms but nothing that we could pinpoint just yet. We have to keep pressing on until it becomes more clear. Day 2 was a break day (I was at work-unable to monitor possible build symptoms). Day 3 was on track and he did well, again with a few questionable symptoms that we are watching. Day 4 was uneventful...until he got a crumb. We took a day off, he had the all-too-familiar rotten egg (sulfur) smelling "reaction diaper" with a low - grade fever but he slept a good nights sleep (through the night), and no vomiting. Today, offered the plums and he didn't want them. Are we still spiraling from the crumb? Or is it the plums? I managed a swipe along his lips this morning, but was not going to fight him....he has enough negative associations with food already, he doesn't need to be forced to eat (and we've already tried this with terrible results in the past, in our desperation to get him to take/tolerate foods, not knowing or understanding what was really going on inside his little body). He has already shown me he can tolerate textures, and he can feed himself with a spoon. We will let him guide his eating patterns as we have let him guide so much of this journey. I don't think he cares for a "breakfast" meal, he seems to do better with a noon-meal. I put away the bowl and decided to try again later. Within 30min or so, his screaming began....high agitation settled by little- not even a ride in the car to take his brothers to school was going to calm him down! We got home and I gave him some of his compounded ibuprofen and his morning iron dose, and just held him for a while - clearly he isn't feeling good. Once he noticed his daddy home (day off work), he went to him for a comforting snuggle where he fell asleep. Again, another "off" thing- we've been fighting him the past few days to take a nap at naptime and now he falls asleep at 9am in the morning! He slept for almost 3hrs, stayed clingy, fussy and not drinking very well all day. The diaper he had this afternoon was suspicious but still not sure what it, and these symptoms are telling us.
Navigating these murky waters. Sure would be nice to have a map....
Navigating murky waters with the diagnosis and knowing what next steps to take, with the coordinated care team, and now with food trials. We are on day 5 of plums but Little Man isn't feeling well. Day 1 went well, he liked them and he ate them himself; there were a few small concerning symptoms but nothing that we could pinpoint just yet. We have to keep pressing on until it becomes more clear. Day 2 was a break day (I was at work-unable to monitor possible build symptoms). Day 3 was on track and he did well, again with a few questionable symptoms that we are watching. Day 4 was uneventful...until he got a crumb. We took a day off, he had the all-too-familiar rotten egg (sulfur) smelling "reaction diaper" with a low - grade fever but he slept a good nights sleep (through the night), and no vomiting. Today, offered the plums and he didn't want them. Are we still spiraling from the crumb? Or is it the plums? I managed a swipe along his lips this morning, but was not going to fight him....he has enough negative associations with food already, he doesn't need to be forced to eat (and we've already tried this with terrible results in the past, in our desperation to get him to take/tolerate foods, not knowing or understanding what was really going on inside his little body). He has already shown me he can tolerate textures, and he can feed himself with a spoon. We will let him guide his eating patterns as we have let him guide so much of this journey. I don't think he cares for a "breakfast" meal, he seems to do better with a noon-meal. I put away the bowl and decided to try again later. Within 30min or so, his screaming began....high agitation settled by little- not even a ride in the car to take his brothers to school was going to calm him down! We got home and I gave him some of his compounded ibuprofen and his morning iron dose, and just held him for a while - clearly he isn't feeling good. Once he noticed his daddy home (day off work), he went to him for a comforting snuggle where he fell asleep. Again, another "off" thing- we've been fighting him the past few days to take a nap at naptime and now he falls asleep at 9am in the morning! He slept for almost 3hrs, stayed clingy, fussy and not drinking very well all day. The diaper he had this afternoon was suspicious but still not sure what it, and these symptoms are telling us.
Navigating these murky waters. Sure would be nice to have a map....
Tuesday, October 12, 2010
Thank you Walgreens!
Little man has needed his medications to be compounded. We are fortunate enough to have a few compounding pharmacy's in town. Walgreens is one of them. When I needed ibuprofen and tylenol, we had the Rx sent to Walgreens. They worked closely with us on it- making sure they were not adding any compounding agents that Little Man would react to. Next came his iron supplement. Unfortunatly, Walgreens did not have the FeSo4 (elemental iron) on stock so they graciously recommended we contact the hospital pharmacy in town so we could get the iron sooner. This was back when his Hemoglobin had dropped to 10 after the bloody stools following corn fail and Neocate and we knew we needed to build him back up. I requested the iron be compounded with Vit.C since Vit.C is deficient in his hemp milk formula and iron is better absorbed with Vit.C (acidic environment). The stomach offers a beautiful acidic environment but taking iron on an empty stomach is rough on the stomach. So, we went ahead and had them compound Vit.C with it. Unfortunatly, I did not think to ask what the Vit.C would be made from if not from corn (ascorbic acid is most often derived from corn) because they compounded it with Yucca root and this only gave us the confirmation that he is allergic to Yucca root (ie Tapioca) as this was his 3rd (and worst) reaction to tapioca -- each reaction becoming more clear, more reaction from less amount. This reaction dropped his hemoglobin from 10 to 7 and 7 is where we sit. He takes iron twice daily to build back up his supply, we are now out of his first Rx of iron so we went back to Walgreens to have them compound it this time (instead of the hospital pharmacy). We picked up his new supply on Friday. I was also able to have an informative discussion with the pharmacist when I picked it up about dosing and best times for good absorption and less stomach aches. Walgreens has not let us down, they did a beautiful job and the iron is less harsh, less metal tasting and mixes better with the water we mix it with....little man barely even gags anymore....what a relief that is! Trust me, the last thing you want to hear from an FPIES child is the sound of them gagging.....
Thank you Walgreens!!
Thank you Walgreens!!
Monday, October 11, 2010
16 months
Little Man is now 16mo. old. Some days I think "where has the time gone"? and other days I can't wait for it to go faster. Most children with FPIES outgrow this condition by their 3rd or 4th birthday. My suspicions are high that it will be closer to his 4th birthday rather than 3rd that we even consider food trials for his trigger foods, esp corn. The understanding is that this is a T-cell response and that these T-cells have a 12-18mo. "memory"; so the common recommendations/practice is to wait 18mo. from diagnosis (or when baseline is found/trigger foods pulled from the diet) to trial this food again. The experiences are that, in most children, the T-cell has forgotten it's attack memory for this protein.
For a 16mo.old, he is on the smaller side. He was born in the 80th% for weight but now hangs around the 10th%. His growth chart looks like a mountain range rather than a curve. This is a fun age, as milestones double by the day, and words start to take off! Just this week, he has added 4 new words to his vocabulary- 4 words that he initiated on his own! The other day, he wanted a sticker on his shirt (the "prize" at the pediatrician's office is a big sticker that we stick on his shirt for him to wear with pride) so he saw a sticker at home and he said "stick" and pointed to his shirt! So proud of him, I gave him two! And it was just a month ago, I was beginning to worry his language was falling behind. Was it developmental? Was it being #4 - so many helpers, why speak? He certainly showed us he processes things well, has a good memory and can follow simple directions but I was beginning to worry about his speech. I know better, that every kid has their own normal and that not everything is done "by the books" but with Little Man- I worry in a different way. I worried that since he wasn't getting good oral-motor development from eating that he will struggle with talking....and I still worry about it. But when he adds new words, I worry a little less (and celebrate a little more). And one less thing to worry about is a good thing.
For a 16mo.old, he is on the smaller side. He was born in the 80th% for weight but now hangs around the 10th%. His growth chart looks like a mountain range rather than a curve. This is a fun age, as milestones double by the day, and words start to take off! Just this week, he has added 4 new words to his vocabulary- 4 words that he initiated on his own! The other day, he wanted a sticker on his shirt (the "prize" at the pediatrician's office is a big sticker that we stick on his shirt for him to wear with pride) so he saw a sticker at home and he said "stick" and pointed to his shirt! So proud of him, I gave him two! And it was just a month ago, I was beginning to worry his language was falling behind. Was it developmental? Was it being #4 - so many helpers, why speak? He certainly showed us he processes things well, has a good memory and can follow simple directions but I was beginning to worry about his speech. I know better, that every kid has their own normal and that not everything is done "by the books" but with Little Man- I worry in a different way. I worried that since he wasn't getting good oral-motor development from eating that he will struggle with talking....and I still worry about it. But when he adds new words, I worry a little less (and celebrate a little more). And one less thing to worry about is a good thing.
Sunday, October 10, 2010
Plums
We are proceeding with food trials, we have picked a fruit next. The catch is, it needs to be a low fructose fruit (higher glucose "load"/ratio than fructose) so that lessens our list to choose from. Plums caught my eye (on the list and in the grocery store). I have decided that all of his first foods need to be cooked first, in hopes that this will break down the structure enough for his sensitive digestion right now. It seems to work for some other sensitive FPIES kids as well, so again- going with what I've learned from other FPIES moms in this mom-driven diagnosis.
We are considering Millet a "pass" for now. The awake-in-the-middle-of-the-night symptoms we were seeing were from his iron supplement being given too late in the evening (and not enough "food" with it). So, we have changed his dosing (along with getting a new compound from Walgreens of a better tolerated/tasting iron) and he appears to be tolerating this better. He will continue getting his millet puffs that he loves so much, but millet porridge (and millet flour cookies) are on the back burner for now and we'll come back to them. Only time will tell and we have to start somewhere; and we have to press on....
So, the other day- I bought plums. I washed them, peeled them (just decided I would also not do the peeling right now), chopped them up and boiled them down with some water to a soft mush. I then put them in the blender. They were ready for him to "trial". I let them cool overnight and they were ready. I also made an attempt at fruit leather with some of the cooked/pureed plums. It didn't completly turn out but I will try again!
We are considering Millet a "pass" for now. The awake-in-the-middle-of-the-night symptoms we were seeing were from his iron supplement being given too late in the evening (and not enough "food" with it). So, we have changed his dosing (along with getting a new compound from Walgreens of a better tolerated/tasting iron) and he appears to be tolerating this better. He will continue getting his millet puffs that he loves so much, but millet porridge (and millet flour cookies) are on the back burner for now and we'll come back to them. Only time will tell and we have to start somewhere; and we have to press on....
So, the other day- I bought plums. I washed them, peeled them (just decided I would also not do the peeling right now), chopped them up and boiled them down with some water to a soft mush. I then put them in the blender. They were ready for him to "trial". I let them cool overnight and they were ready. I also made an attempt at fruit leather with some of the cooked/pureed plums. It didn't completly turn out but I will try again!
Saturday morning, I put a few teaspoons in a bowl for him and tried to feed him. He turned his head away. I swipped his lips with a little "flavor" of it and he smiled, opened his mouth and let me feed him a few bites!! He was loving it! Then he started turning his head again. I got up to make his brothers breakfast, while his daddy stayed beside him at the table, encouraging him. He picked up his spoon and fed himself!!
This is EXCITING to see. Now, I know he is almost 16mo., but with respect to food he is more like a 6mo. old- exploring new foods all over again. He has not had this kind of food, has not had a "diet" for 8mo....and he still remembers/knows what to do!! AND he LIKES them!! Puree food that he likes, and fed himself! We celebrate the little moments around here....Little Man was proud of himself too... 
Day 2 of plums was today, and he ate them well today too....today he let his biggest brother feed him!! I am not sure who was happier about that- little man or his big brother!
So far, things are going well. We've had a few small incidents that are already "muddying" the picture -- some possible bath soap ingestion last night and a crumb ingestion this morning. We will take tomorrow off (I work and also don't have anymore cooked plums ready) so, we will look to resume Tuesday morning if he continues to do well through the night tonight and tomorrow.
Friday, October 8, 2010
My favorite show...
Comes from the 14foot window in my living room. Little Man likes to watch this "channel" too. These days of anemia- he tires easily and I think he gets cold easily too, so with the cooler fall weather he isn't wanting to play outside as much. But he loves to watch the fun from our family room window.
We are proceeding to plums tomorrow. I cooked them down, and then pureed them. Typically, little man doesn't like puree foods- he doesn't like to be spoon fed. He has an aversion to the spoon- too many months of us trying to figure out what foods was causing his symptoms, why he wasn't eating them, why he was spitting up after eating, throwing up in his sleep, why he just didn't want to eat but seemed so hungry. He does however enjoy feeding himself. So, I am attempting to make Fruit Leather to see if he would like this as a snack, to add to his millet puffs that he loves so much.
Tomorrow we start our plum trial.
Thursday, October 7, 2010
Two Hours every Two Days.....
I'm in my kitchen making formula for my Little Man....
My Little Man has a corn FPIES trigger. In hindsight, it may be one of his main/first triggers as he reacted diaper rash ointments and diapers only a few days old. There is corn starch/talc in diaper creams and in some diaper linings. He then reacted to Tylenol at 2 1/2mo. old when I have given it to him for pain he was having (that I now know was from that formula trial we did at that time). There is high fructose corn syrup and citric acid (among other things) in infant Tylenol. He seemed to tolerate children's Motrin better later on when given for pain and teething, there is no corn syrup in Children's Motrin (although there is citric acid so he wasn't completly tolerating that either, which we suspected but weren't sure). He reacted to all formula trials - we have no doubts that he has a dairy trigger but likely his corn trigger was compounding this. I nursed him while giving up dairy and soy, then wheat in my diet - all to no avail....now we know the corn I had increased in my diet was likely why. FPIES triggers (violent vomiting, diarrhea, dehydration) do not happen through breastmilk but sensitivity's do for many FPIES kids (just the same as a milk intolerant or another allergy will be sensitized through breastmilk). The infant reacts to trace proteins in the mothers milk and anything from "simple" reflux to bloody stools can result from this reaction to a sensitive/immature gut. My Little Man was reacting to these proteins in my breastmilk, after beginning solids, the sensitivity only was heightened and his body was beginning the attacking mechanisms of FPIES to: dairy, soy, rice, corn and triggers yet to be identified (but hopefully no more!). My Little Man continued to react to the trace corn proteins in the corn syrup solids in the formula's- even the elemental formula's that undergo more strict "straining" of these proteins. For so many months, my little man suffered because of the "assault" from the trace corn proteins- some days were worse than others, some days were unbearable, but everyday he had pain.
We have fully moved away from any commercial formula. I would LOVE it if a formula company would hear my plea (maybe I need to write more letters?) and produce a formula that my Little Man could thrive on but so far those have been empty plea's so I began the process of making him a formula. I make it out of Hemp milk, hemp high protein, oil and arrowroot starch. The catch is I have to cook this arrowroot starch down to a syrup because Little Man can not tolerate it any other way - he continues to have problems with carbohydrate digestion but by slow cooking it over a low heat (in the hemp milk)- it breaks down the carbohydrate to an easier digestible form. It takes 1hr. for 1batch, and I can do 2 batches to last 2days- but anything longer and the formula starts to separate and breakdown. So, every 2 days- I am in my kitchen for 2hours.
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My Little Man has a corn FPIES trigger. In hindsight, it may be one of his main/first triggers as he reacted diaper rash ointments and diapers only a few days old. There is corn starch/talc in diaper creams and in some diaper linings. He then reacted to Tylenol at 2 1/2mo. old when I have given it to him for pain he was having (that I now know was from that formula trial we did at that time). There is high fructose corn syrup and citric acid (among other things) in infant Tylenol. He seemed to tolerate children's Motrin better later on when given for pain and teething, there is no corn syrup in Children's Motrin (although there is citric acid so he wasn't completly tolerating that either, which we suspected but weren't sure). He reacted to all formula trials - we have no doubts that he has a dairy trigger but likely his corn trigger was compounding this. I nursed him while giving up dairy and soy, then wheat in my diet - all to no avail....now we know the corn I had increased in my diet was likely why. FPIES triggers (violent vomiting, diarrhea, dehydration) do not happen through breastmilk but sensitivity's do for many FPIES kids (just the same as a milk intolerant or another allergy will be sensitized through breastmilk). The infant reacts to trace proteins in the mothers milk and anything from "simple" reflux to bloody stools can result from this reaction to a sensitive/immature gut. My Little Man was reacting to these proteins in my breastmilk, after beginning solids, the sensitivity only was heightened and his body was beginning the attacking mechanisms of FPIES to: dairy, soy, rice, corn and triggers yet to be identified (but hopefully no more!). My Little Man continued to react to the trace corn proteins in the corn syrup solids in the formula's- even the elemental formula's that undergo more strict "straining" of these proteins. For so many months, my little man suffered because of the "assault" from the trace corn proteins- some days were worse than others, some days were unbearable, but everyday he had pain.
We have fully moved away from any commercial formula. I would LOVE it if a formula company would hear my plea (maybe I need to write more letters?) and produce a formula that my Little Man could thrive on but so far those have been empty plea's so I began the process of making him a formula. I make it out of Hemp milk, hemp high protein, oil and arrowroot starch. The catch is I have to cook this arrowroot starch down to a syrup because Little Man can not tolerate it any other way - he continues to have problems with carbohydrate digestion but by slow cooking it over a low heat (in the hemp milk)- it breaks down the carbohydrate to an easier digestible form. It takes 1hr. for 1batch, and I can do 2 batches to last 2days- but anything longer and the formula starts to separate and breakdown. So, every 2 days- I am in my kitchen for 2hours.
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Monday, October 4, 2010
Pass or Fail?
I thought I would know by now if Millet was looking like "pass" or "fail"....unfortunately if I was to "call it" now, it would be fail. Last night, little man was only awake once but he was in pain when he was awake- and it was all-too-familiar discomfort, but after almost an hour - I did give him some of his compounded corn-free ibuprofen and he then settled right down and slept another few hours, only to wake up too early and too grumpy. :( But, here again, not enough symptoms to "call" it but things are starting to add up with too much familiarity and beginning to make me worry. I then changed a diaper, lets just call it "weird", and "concerning" but not fully a reaction diaper. He remained grumpy while I got his brothers ready for school and I got ready for work.
Now, begins the guessing game - is this from the baking powder with corn starch? The crumb or two he may have ingested? Could be. Is it from baking soda or cream of tarter? Doubtful but could be. Or, worst yet- is this an FPIES trigger to millet or an intolerance to millet? At that point- I'm leaning towards intolerance and taking a break to see what that does to his system and see if the picture can become less muddy over the next few days. I work 4 days this week, so won't be home to monitor him anyway so a good time to just take a simple break.
Little man had a lab draw set up for this morning. We've been getting frequent checks on his labs, with his FPIES being a chronic illness- compounding situations have been sneaking up on us but we are learning more and more about FPIES and how things affect Little Man. These lab checks take a lot out of him and this morning was no exception- especially since they had to try 4 times to get the vein! Poor little man. Results came back today and a short discussion with our pediatrician helped to calm my nerves between his labs being off and his questionable build reaction, with me being at work unable to do much about any of it. His hemoglobin/hemotocrit and Iron are holding but not improved at all; although the good news is that his reticulocytes count is improved- showing his body is nicely responding to the iron supplement. It will take awhile (6weeks or so) to begin to see a tiny bump in his hemoglobin/hemotocrit and iron levels from this though....it will be a slow process but we still feel this remains a better option than a transfusion at this time. We are beginning to check other nutritional panel labs as well, to be sure his homemade formula is still helping him thrive (because as far as pain free and baseline and weight gain goes, he is thriving on it). His other labs look ok.
But that doesn't change the fact that he needs a tiny menu to round up his nutrition of micro nutrients. We are fighting hard to get him this. But in the meantime, he can't afford a set back- so we have to continue to proceed very slowly. We remain between that rock and hard place.....he needs more nutrition in his diet, but he can't afford a reaction. Does anyone have a crystal ball to see what we should even try next? Do we continue with the millet? I still feel like we should- I have been going primarily on instincts this whole time, and letting Little Man guide us along. He isn't reacting during the day and in fact, he may even be improved- behavior, sleep, comfort, mood, etc. But last night/this morning threw me enough of a warning sign to signal my instincts to take a break/slow down until the picture is less muddy (teething pain? cold? reaction? hungry?). Maybe put millet to the side and get a fruit but then again- left in the same place we were last week- he won't eat a fruit...millet he was eating (another sign that his body isn't reacting to it- he wants it).
Today, I'm left with FPIES=Feeling Powerless In Every Sense; tomorrow will be better. It is day by day and sometimes moment by moment around here. And today, I am reminded of that.
Now, begins the guessing game - is this from the baking powder with corn starch? The crumb or two he may have ingested? Could be. Is it from baking soda or cream of tarter? Doubtful but could be. Or, worst yet- is this an FPIES trigger to millet or an intolerance to millet? At that point- I'm leaning towards intolerance and taking a break to see what that does to his system and see if the picture can become less muddy over the next few days. I work 4 days this week, so won't be home to monitor him anyway so a good time to just take a simple break.
Little man had a lab draw set up for this morning. We've been getting frequent checks on his labs, with his FPIES being a chronic illness- compounding situations have been sneaking up on us but we are learning more and more about FPIES and how things affect Little Man. These lab checks take a lot out of him and this morning was no exception- especially since they had to try 4 times to get the vein! Poor little man. Results came back today and a short discussion with our pediatrician helped to calm my nerves between his labs being off and his questionable build reaction, with me being at work unable to do much about any of it. His hemoglobin/hemotocrit and Iron are holding but not improved at all; although the good news is that his reticulocytes count is improved- showing his body is nicely responding to the iron supplement. It will take awhile (6weeks or so) to begin to see a tiny bump in his hemoglobin/hemotocrit and iron levels from this though....it will be a slow process but we still feel this remains a better option than a transfusion at this time. We are beginning to check other nutritional panel labs as well, to be sure his homemade formula is still helping him thrive (because as far as pain free and baseline and weight gain goes, he is thriving on it). His other labs look ok.
But that doesn't change the fact that he needs a tiny menu to round up his nutrition of micro nutrients. We are fighting hard to get him this. But in the meantime, he can't afford a set back- so we have to continue to proceed very slowly. We remain between that rock and hard place.....he needs more nutrition in his diet, but he can't afford a reaction. Does anyone have a crystal ball to see what we should even try next? Do we continue with the millet? I still feel like we should- I have been going primarily on instincts this whole time, and letting Little Man guide us along. He isn't reacting during the day and in fact, he may even be improved- behavior, sleep, comfort, mood, etc. But last night/this morning threw me enough of a warning sign to signal my instincts to take a break/slow down until the picture is less muddy (teething pain? cold? reaction? hungry?). Maybe put millet to the side and get a fruit but then again- left in the same place we were last week- he won't eat a fruit...millet he was eating (another sign that his body isn't reacting to it- he wants it).
Today, I'm left with FPIES=Feeling Powerless In Every Sense; tomorrow will be better. It is day by day and sometimes moment by moment around here. And today, I am reminded of that.
Sunday, October 3, 2010
4 Ingredients = 1 "cookie"
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Normal is a setting on the dishwasher....
It certainly isn't a setting in an FPIES world! That statement is meant to mean- normal is subjective, it refers to objects activity and not lives. Normal is whatever you want it to be. But last night, sitting around the table - all 6 of us....I felt normal. I looked at all 4 of my boys - what, I'm the mother of 4 boys? When did this happen? Where has my life gone over the past year that I haven't even been able to fully absorb that I have 4 boys. Four beautiful boys (yes, a mother can call her boys beautiful).
Little man seems to be tolerating the Millet well so far. He is not having any daytime adverse effects at all, not one. Not one burp, gas attack, suspect diaper, spit up, lethargy, or vomiting of course. In fact he has been so content!! Nighttime isn't as quiet, he is awake at odd times, for too long of a time. I am still not sure what to call this- as this has happened before leading up to a reaction but it is also happens for benign, "normal" (there's that setting again) baby/toddler reasons. So, we press on. He has been getting millet porridge in the morning, in increasing amounts daily. He also is enjoying his millet puffs again, as a "snack" and as something to eat when we sit at the table as a family.
Little man enjoyed sitting with us at the table at dinner (real, actual dinner of pot roast/potatoes/etc.!). He ate his millet puffs one by one, and then he even stayed there while I cleared the table and cleaned up the dishes. His daddy couldn't resist how sweet (and normal) he was being so grabbed a few pictures while Little Man "talked" to his big brother.
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This dinner was the end of a nice, "normal" fall day yesterday. We enjoyed real family time, normal pre-FPIES activities- all together as a family. I love fall, so we went to a local Apple Orchard/Corn Maze. Ok, ok- I know, you're thinking- you took your corn allergic kid to a corn maze? Well, he was safe and enjoyed the ride and view....
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Little man seems to be tolerating the Millet well so far. He is not having any daytime adverse effects at all, not one. Not one burp, gas attack, suspect diaper, spit up, lethargy, or vomiting of course. In fact he has been so content!! Nighttime isn't as quiet, he is awake at odd times, for too long of a time. I am still not sure what to call this- as this has happened before leading up to a reaction but it is also happens for benign, "normal" (there's that setting again) baby/toddler reasons. So, we press on. He has been getting millet porridge in the morning, in increasing amounts daily. He also is enjoying his millet puffs again, as a "snack" and as something to eat when we sit at the table as a family.
Little man enjoyed sitting with us at the table at dinner (real, actual dinner of pot roast/potatoes/etc.!). He ate his millet puffs one by one, and then he even stayed there while I cleared the table and cleaned up the dishes. His daddy couldn't resist how sweet (and normal) he was being so grabbed a few pictures while Little Man "talked" to his big brother.
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This dinner was the end of a nice, "normal" fall day yesterday. We enjoyed real family time, normal pre-FPIES activities- all together as a family. I love fall, so we went to a local Apple Orchard/Corn Maze. Ok, ok- I know, you're thinking- you took your corn allergic kid to a corn maze? Well, he was safe and enjoyed the ride and view....
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Friday, October 1, 2010
Millet day 2, um...I mean day 5
We are trialing Millet. Yes, we started this a few weeks ago, we stopped it before we could finish. I have wanted to get back to it and know for sure. Little Man needs iron (this has some- but again, another plant based source). He also really needs Vit.C. I bought berries, but he would not touch them. How do you trial when they won't touch the food? Then I had a thought, if I did the millet and it was a "pass"- I could cook the berries/fruits and use the juice to add new flavors to the millet and he could get used to the flavor as well as do a trial on the fruit at the same time....AND get Vit.C. So, millet trial it is.
Yesterday morning, he wasn't thrilled but I got some on his lip and he licked it and then began ASKING for more and LETTING me FEED him!! I was giddy! We had to distract him so I could pull the bowl away (can't do too much in case he would react!). This morning, he wasn't as excited- he was opening his mouth but not very wide. I said to Little Man's daddy who was standing by - "this makes me nervous when he doesn't want to eat it"....to which he leaned over and whispered in Little Man's ear..."it's ok- she would get nervous if you wanted to eat up the whole bowl full too". Yep- can't win with this. Which is why I have been cautiously optimistic all day....super content or reaction tired? Fussy from teething top molars or tummy ache? Achy from an oncoming cold or reacting? Ugh- I did what I do best when I need to be distracted....I cleaned and organized! I got a lot done this morning but then after his nap he was pretty fussy; he settled down through the evening though so will remain hopeful. Day by day, moment by moment.....
Yesterday morning, he wasn't thrilled but I got some on his lip and he licked it and then began ASKING for more and LETTING me FEED him!! I was giddy! We had to distract him so I could pull the bowl away (can't do too much in case he would react!). This morning, he wasn't as excited- he was opening his mouth but not very wide. I said to Little Man's daddy who was standing by - "this makes me nervous when he doesn't want to eat it"....to which he leaned over and whispered in Little Man's ear..."it's ok- she would get nervous if you wanted to eat up the whole bowl full too". Yep- can't win with this. Which is why I have been cautiously optimistic all day....super content or reaction tired? Fussy from teething top molars or tummy ache? Achy from an oncoming cold or reacting? Ugh- I did what I do best when I need to be distracted....I cleaned and organized! I got a lot done this morning but then after his nap he was pretty fussy; he settled down through the evening though so will remain hopeful. Day by day, moment by moment.....
Coping in a New World
I've read this excerpt before, on raising a child with a disability. I don't know if FPIES is a disability, at least not a lifetime one but it sure disables my Little Man's life right now, as well as our families. We have developed our new normal, settling into this new world, but everyday brings new challenges, new milestones, new fears, new navigation's in the murky waters of FPIES world.
Coping is acceptance.
This spells out coping to me. I have Faith there is a bigger plan for us in the universe. Sometimes it requires ongoing evaluation of the road map you've been handed to figure out what direction you want/need to go in....and to take it ONE step at a time...only one step at a time....sometimes it is moment by moment, most of the time it is day by day- I don't go much further than that with this illness....I know better- things change course FAST and I'll get lost quickly trying to look too far ahead.
WELCOME TO HOLLAND
by
Emily Perl Kingsley.
c1987 by Emily Perl Kingsley. All rights reserved
I am often asked to describe the experience of raising a child with a disability - to try to help people who have not shared that unique experience to understand it, to imagine how it would feel. It's like this......
When you're going to have a baby, it's like planning a fabulous vacation trip - to Italy. You buy a bunch of guide books and make your wonderful plans. The Coliseum. The Michelangelo David. The gondolas in Venice. You may learn some handy phrases in Italian. It's all very exciting.
After months of eager anticipation, the day finally arrives. You pack your bags and off you go. Several hours later, the plane lands. The stewardess comes in and says, "Welcome to Holland."
"Holland?!?" you say. "What do you mean Holland?? I signed up for Italy! I'm supposed to be in Italy. All my life I've dreamed of going to Italy."
But there's been a change in the flight plan. They've landed in Holland and there you must stay.
The important thing is that they haven't taken you to a horrible, disgusting, filthy place, full of pestilence, famine and disease. It's just a different place.
So you must go out and buy new guide books. And you must learn a whole new language. And you will meet a whole new group of people you would never have met.
It's just a different place. It's slower-paced than Italy, less flashy than Italy. But after you've been there for a while and you catch your breath, you look around.... and you begin to notice that Holland has windmills....and Holland has tulips. Holland even has Rembrandt's.
But everyone you know is busy coming and going from Italy... and they're all bragging about what a wonderful time they had there. And for the rest of your life, you will say "Yes, that's where I was supposed to go. That's what I had planned."
And the pain of that will never, ever, ever, ever go away... because the loss of that dream is a very very significant loss.
But... if you spend your life mourning the fact that you didn't get to Italy, you may never be free to enjoy the very special, the very lovely things ... about Holland.
Coping is acceptance.
This spells out coping to me. I have Faith there is a bigger plan for us in the universe. Sometimes it requires ongoing evaluation of the road map you've been handed to figure out what direction you want/need to go in....and to take it ONE step at a time...only one step at a time....sometimes it is moment by moment, most of the time it is day by day- I don't go much further than that with this illness....I know better- things change course FAST and I'll get lost quickly trying to look too far ahead.
WELCOME TO HOLLAND
by
Emily Perl Kingsley.
c1987 by Emily Perl Kingsley. All rights reserved
I am often asked to describe the experience of raising a child with a disability - to try to help people who have not shared that unique experience to understand it, to imagine how it would feel. It's like this......
When you're going to have a baby, it's like planning a fabulous vacation trip - to Italy. You buy a bunch of guide books and make your wonderful plans. The Coliseum. The Michelangelo David. The gondolas in Venice. You may learn some handy phrases in Italian. It's all very exciting.
After months of eager anticipation, the day finally arrives. You pack your bags and off you go. Several hours later, the plane lands. The stewardess comes in and says, "Welcome to Holland."
"Holland?!?" you say. "What do you mean Holland?? I signed up for Italy! I'm supposed to be in Italy. All my life I've dreamed of going to Italy."
But there's been a change in the flight plan. They've landed in Holland and there you must stay.
The important thing is that they haven't taken you to a horrible, disgusting, filthy place, full of pestilence, famine and disease. It's just a different place.
So you must go out and buy new guide books. And you must learn a whole new language. And you will meet a whole new group of people you would never have met.
It's just a different place. It's slower-paced than Italy, less flashy than Italy. But after you've been there for a while and you catch your breath, you look around.... and you begin to notice that Holland has windmills....and Holland has tulips. Holland even has Rembrandt's.
But everyone you know is busy coming and going from Italy... and they're all bragging about what a wonderful time they had there. And for the rest of your life, you will say "Yes, that's where I was supposed to go. That's what I had planned."
And the pain of that will never, ever, ever, ever go away... because the loss of that dream is a very very significant loss.
But... if you spend your life mourning the fact that you didn't get to Italy, you may never be free to enjoy the very special, the very lovely things ... about Holland.
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