Monday, February 7, 2011

Lucca's Scan and Info for Thought

Today we went in at 7am to have Lucca's Nuclear Medicine Gastric Emptying Scan. This test was going to tell us if Lucca's stomach is having trouble emptying properly, which would explain why food is staying in his stomach so long and coming up un-digested hours after he eats. This is a test he would have to have done before we even went ahead with the surgery (if that is what we chose to do).
I found an article on a website last week, thanks to my dear friend Tricia who sent me the site, talking about how "Motility Disorders are commonly mistaken for reflux in infants." So of course that caught my eye.. It had a chart on the page comparing symptoms of Reflux and symptoms of Delayed Gastric Emptying:
(I will put in red the ones that Lucca has or exhibits)
Passive Regurgitation (spit up)
Occasional vomiting (1x a day)
Regurgitation during/after feedings
Irritability during and after feeding
Nausea unusual
Gagging and choking are rare
Pain in throat and chest
Food aversion or refusal
Wet burps or hiccups
Failure to thrive (uncommon)
Malnutrition/dehydration (unusual)
Bloating unusual
Respiratory symptoms such as cough, hoarse voice, choronic ear/sinus infections, aspiration, apnea, etc.
Delayed Gastric Emptying
Forceful vomiting, sometimes projectile (sometimes)
Frequent vomiting (2x a day or more)
Vomiting at any time of the day, long after feedings
Iritability at any time of the day
Nausea common
Retching and gagging are common
Pain usually in the belly and intestines
Food aversion or refusal
Excessive burping
Failure to thrive (more common)
Bloating common
Respiratory problems such as cough, hoarse voice, chronic ear/sinus infections, aspiration, apnea, etc.

So is it just me, or does everyone see more red under the delayed gastric empyting column??? And then if that wasn't enough to get you wondering, the next page says this:
"If your child has been diagnosed with reflux but you suspect that he may actually have a motility problem of the esophagus, stomach or small intestine, the following criteria may help you decide if your child needs motility testing: (again I will mark in red the ones Lucca has)
* Reflux medications (such as Prevasid, Prilosec, Nexium, etc) have not improved symptoms.. DING DING DING!!
* Spitting up persists past the age of 12 months
* Vomiting or retching occurs more than once a day, every day
* Vomiting is forceful or projectile on a regular basis
* Vomit contains undigested food from many hours earlier
* Choking or gagging occurs frequently
* Constant, frequent or persistent abdominal pain
* Bloating occurs daily
* Diarrhea occurs daily, especially with paleness or sweating
* Failure to thrive, dehydration or malnutrition have been diagnosed"
So this was enough info for me to bring it to the doctor's attention, who agreed, that Lucca may have this "Delayed Gastric Emptying Disorder, which could actually be the source of his reflux.. So today's test was supposed to show if indeed he has an issue "emptying" his stomach.
He had to fast for 8 hours ( so he hadn't had anything to eat since 8 last night) and when we got there they came him a scrambled egg mixed with the radioactive material.. he started eating it ok, and then started gagging and didn't want anymore of it, so he washed it down with a little SILK and that was his breakfast... we were so worried that this was an all day thing and he was going to be so hungry and cranky because that is all he could eat for the entire duration of the study. The first hour they took pictures every ten minutes. After each picture it looked like his stomach was emptying so quickly, which we couldn't believe because he is constantly throwing up undigested food hours after he eats! but by the end of the first hour Lucca's stomach still wasn't emptied 50 percent so we had to go into the second hour where they would take pictures every 20 minutes. Lucca was such a good boy and was giggling and layed so still when they took his pictures. After the first pictures in the second hour he fell fast asleep and slept on the table the rest of the procedure :) He was so precious! At the end of the second hour the tech told us that he definitely has a delay in emptying and that his GI doctor would call me with the specifics. We are actually kinda excited about this because this can be treated with medicine (Erythromyecin) which should make the food contents flow through quicker and in turn hopefully get more food past his stomach and less coming back up.. and this means HOPEFULLY NO SURGERY!! So right now this is looking good for us and for Lucca :) We don't want to have to do surgery!

My lil guy was so good and fell asleep on the table :)

1 comment:

Schauss Family Happenings said...

How great! Did Jodi e-mail you Mark Quattebaum's contact info? His son is 10 or 11ish and they have gone through many of these tests and such. He would definately be a great point of contact for you...especially since his son has PMS, too!