The plan for stomach viruses

[Guest guest]

Brigitte,

I think I was wrong about 's post. I think she sent it to

me in a private email, comparing how similar Max and are

when they get a stomach bug.

The basic plan is as follows:

Admission to the hospital for an IV with D10. (Max, however, gets

D5.5 because the D10 burns out his veins too quickly.) If, after a

24 hour gut rest, the child is not spilling ketones and not vomiting

anymore, then you can introduce clear liquids. If they are

tolerated for the next 4-6 hours, then you can try soft foods. Once

they are tolerated, then you can move onto a regular diet.

This has to be done slowly, however. Max will never keep food down

for the first 48 hours at least. After 24 hours, however, we allow

him to start with clears. He will still spit them up, but at least

he gets the taste of food. The next step for Max is to try dry

cereal and other things that have more weight to them. Liquids are

so easy to spit up, while solid food is heavier and more likely to

stay down. No matter what, Max will not keep enough food down until

the 4th day. Then he seems to be able to keep more and more down as

time goes on. By the 5th day he is eating regular foods and feeling

much better and can go home.

The child MUST be kept on IV fluids during all of this time. You

need the backup to keep those ketones away. If all is suddenly

stopped, there is a chance that ketones will return and then you are

back to square one again.

This is the basic routine for our kids. Please, however, check with

your doctor and make up a plan. We have this one in place so that

the pediatricians, no matter who is on-call, will know what to do

and which orders to write. Having a plan in advance makes all the

difference in the world.

Jodi Z

[Guest guest]

Jodi,

I am helping out with finding valuable info in the lissterve for the RSS

guidebook, and this

has caused me to reread thins that I may not have had much interest in before.

I will

admit, I only skimmed the stuff about spilling ketones, because I didn't think

this applied

to . After reading much info, including the message you just posted, I

am now

questioning whether this may be an issue. We (all 6 of us) just dealt with a

nasty stomach

virus, and both & ended up in the E.R. was able to go

home after

4 hours of IV fluids, but (non-RSS) stayed for 4 days in the hospital &

followed the

course you described with Max. He was on Pedialyte for several days, which I

thought was

fine, but now I am questioning whether it really was after you said that would

not prevent

him from spilling ketones. I am wondering if there is a need to see if he

spills ketones as

a baseline, and then is this something I should do if and when he gets sick

again?

Also, though has been in the hospital MANY times for illnesses, tests,

etc. I never

requested or even knew to request an IV with D10 (keep in mind most of his

hospitalizations were prior to me even being a member of MAGIC). In a few

weeks, he will

be having an endoscopy & pH probe, and I know he will have to be NPO after

midnight and

will get an IV. For any tests that he has recently (in the past few years), it

never mattered

to me that he had to be NPO. I never saw any effects from that, and isn't like

he cared (he

never has hunger). So, even if I think it won't be a problem for him (physical

signs), is this

something I should rethink? In other words, should he follow the same IV with

D10

protocol in the future?

Kim C.

> Brigitte,

>

> I think I was wrong about 's post. I think she sent it to

> me in a private email, comparing how similar Max and are

> when they get a stomach bug.

>

> The basic plan is as follows:

>

> Admission to the hospital for an IV with D10. (Max, however, gets

> D5.5 because the D10 burns out his veins too quickly.) If, after a

> 24 hour gut rest, the child is not spilling ketones and not vomiting

> anymore, then you can introduce clear liquids. If they are

> tolerated for the next 4-6 hours, then you can try soft foods. Once

> they are tolerated, then you can move onto a regular diet.

>

> This has to be done slowly, however. Max will never keep food down

> for the first 48 hours at least. After 24 hours, however, we allow

> him to start with clears. He will still spit them up, but at least

> he gets the taste of food. The next step for Max is to try dry

> cereal and other things that have more weight to them. Liquids are

> so easy to spit up, while solid food is heavier and more likely to

> stay down. No matter what, Max will not keep enough food down until

> the 4th day. Then he seems to be able to keep more and more down as

> time goes on. By the 5th day he is eating regular foods and feeling

> much better and can go home.

>

> The child MUST be kept on IV fluids during all of this time. You

> need the backup to keep those ketones away. If all is suddenly

> stopped, there is a chance that ketones will return and then you are

> back to square one again.

>

> This is the basic routine for our kids. Please, however, check with

> your doctor and make up a plan. We have this one in place so that

> the pediatricians, no matter who is on-call, will know what to do

> and which orders to write. Having a plan in advance makes all the

> difference in the world.

>

> Jodi Z