Guest guest Posted September 22, 2005 Report Share Posted September 22, 2005 We are home from the GI and I learned some interesting things. Well, I did not learn them actually. I already knew them and he confirmed them. Several things are going on here. One is that Max is taking Tetracycline for his acne. This can be causing some ulcers in his esophagus which are irritating the diaphragm and causing the hiccups which he says now are called rumination. That's because a cycle has started that is very difficult to break. (We have faced this rumination before in the form of uncontrollable vomiting.) The next is that Max's gastric emptying is surely delayed. This would add to the Tetracycline issue because it could be sitting in Max's stomach for longer periods of time than it would for most people. In addition, the delayed emptying causes his stomach to become enlarged and that causes irritation, leading to the hiccups/rumination. Also, along with the delayed emptying and larger stomach, there could be and probably is pain there, but not pain that Max would necessarily feel. And pain in the gut can cause the diaphragm to contract. Now add the fact that Max has grown about 2+ inches since May. He is obviously eating more to fuel that extremely accelerated growth. The extra amounts of food put into an already overstressed stomach makes for more trouble. The there is that " stress " word. That can also cause irritation. We all know that Max is an anxious kid and can easily become overwhelmed. Stress causes more acid in the gut and more irritation. What do we do? Apparently there is a breathing method that can be used to control the rumination. But the GI did not know how to do it. Another GI specializes in this, but he was unable to locate him. Great. We also have to address the delayed emptying. Max is supposed to eat small, more frequent meals. (Hello - I've been telling him that for weeks now!!!) He cannot have any soda or anything that could irritate his stomach or add extra air in there. The GI is considering trying erythromycin to speed the emptying, but he is not sure of how it would interact with the other meds he takes. That will be checked out tomorrow with the psychiatrist when Max sees her. He also wants to do an endoscopy next week if the hiccups continue over the weekend. He can check to see if there are any ulcers and, if necessary, restretch the opening of the pylorus. It is possible that there is scar tissue from the pyloraplasty Max had 2 years ago. That would narrow the opening. The psychiatrist - she is going to begin to change Max's meds around to address the stress issue. He's due for a change anyway. Previously he took Zoloft and had great success with it, but he had to stop it when he took Cisapride. Now that the med is not being made anymore, he can go back on Zoloft and possibly Risperdal again. So, we have some explanations, no cure, and a wait and see answer. The only good news is that the hiccups/rumination are not continuous right now. They are still coming on, but he gets some breaks inbetween. I'm exhausted both physically and emotionally. I just need a good cry. Jodi Z Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 22, 2005 Report Share Posted September 22, 2005 Jodi - We are all here. Please cry. It does help. I'm sorry. I'm sorry because of your pain, your frustration, and the continued wait and see answers. And poor Max. My thoughts, prayers and hugs are with you both. Please - both try to get some rest when you can. The weekend is almost here. I'm here if you need me. - H > We are home from the GI and I learned some interesting things. > Well, I did not learn them actually. I already knew them and he > confirmed them. > > Several things are going on here. One is that Max is taking > Tetracycline for his acne. This can be causing some ulcers in his > esophagus which are irritating the diaphragm and causing the hiccups > which he says now are called rumination. That's because a cycle has > started that is very difficult to break. (We have faced this > rumination before in the form of uncontrollable vomiting.) > > The next is that Max's gastric emptying is surely delayed. This > would add to the Tetracycline issue because it could be sitting in > Max's stomach for longer periods of time than it would for most > people. In addition, the delayed emptying causes his stomach to > become enlarged and that causes irritation, leading to the > hiccups/rumination. > > Also, along with the delayed emptying and larger stomach, there > could be and probably is pain there, but not pain that Max would > necessarily feel. And pain in the gut can cause the diaphragm to > contract. > > Now add the fact that Max has grown about 2+ inches since May. He > is obviously eating more to fuel that extremely accelerated growth. > The extra amounts of food put into an already overstressed stomach > makes for more trouble. > > The there is that " stress " word. That can also cause irritation. > We all know that Max is an anxious kid and can easily become > overwhelmed. Stress causes more acid in the gut and more > irritation. > > What do we do? Apparently there is a breathing method that can be > used to control the rumination. But the GI did not know how to do > it. Another GI specializes in this, but he was unable to locate > him. Great. > > We also have to address the delayed emptying. Max is supposed to > eat small, more frequent meals. (Hello - I've been telling him that > for weeks now!!!) He cannot have any soda or anything that could > irritate his stomach or add extra air in there. The GI is > considering trying erythromycin to speed the emptying, but he is not > sure of how it would interact with the other meds he takes. That > will be checked out tomorrow with the psychiatrist when Max sees > her. He also wants to do an endoscopy next week if the hiccups > continue over the weekend. He can check to see if there are any > ulcers and, if necessary, restretch the opening of the pylorus. It > is possible that there is scar tissue from the pyloraplasty Max had > 2 years ago. That would narrow the opening. > > The psychiatrist - she is going to begin to change Max's meds around > to address the stress issue. He's due for a change anyway. > Previously he took Zoloft and had great success with it, but he had > to stop it when he took Cisapride. Now that the med is not being > made anymore, he can go back on Zoloft and possibly Risperdal > again. > > So, we have some explanations, no cure, and a wait and see answer. > The only good news is that the hiccups/rumination are not continuous > right now. They are still coming on, but he gets some breaks > inbetween. > > I'm exhausted both physically and emotionally. I just need a good > cry. > > Jodi Z Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 23, 2005 Report Share Posted September 23, 2005 Hey Jodi, Just a thought here with the Tetracycline and Max's hiccups. Can you use a topical solution of it, instead of an oral one? Also, how about changing to a different acne medication if the Tetracycline is irritating his oesophagus? We have gotten excellent results with Differin Topical gel. ne > We are home from the GI and I learned some interesting things. > Well, I did not learn them actually. I already knew them and he > confirmed them. > > Several things are going on here. One is that Max is taking > Tetracycline for his acne. This can be causing some ulcers in his > esophagus which are irritating the diaphragm and causing the hiccups > which he says now are called rumination. That's because a cycle has > started that is very difficult to break. (We have faced this > rumination before in the form of uncontrollable vomiting.) > > > Jodi Z Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 23, 2005 Report Share Posted September 23, 2005 Oh Jodi, what can I do to help? I'd offer my company but at the same time I'm sure you just want to veg out when the opportunity arises. If you want company, I am a few minutes away. I was going to try to come to your classroom yesterday when I picked up but was afraid of the woman in the office chasing me down the halls. I'll try today - I'm a fast runner sometimes. Hopefully between the GIs and the psychiatrist that can come up with something and talk with one another quickly. Please let me know if there is anything I can do. Is Max at school today? Would you like me to go check on him during the day to see if there is anything he needs? You can give him my work number if he needs me to bring something to him. I'm sure he wouldn't be comfortable calling but if you stress to him that it's okay or if he calls you at school, do not hesitate to call me. I can be in Madison in 10-15 minutes at that point (I can get through Madison fast - ha). B Jodi Zwain wrote: We are home from the GI and I learned some interesting things. Well, I did not learn them actually. I already knew them and he confirmed them. Several things are going on here. One is that Max is taking Tetracycline for his acne. This can be causing some ulcers in his esophagus which are irritating the diaphragm and causing the hiccups which he says now are called rumination. That's because a cycle has started that is very difficult to break. (We have faced this rumination before in the form of uncontrollable vomiting.) The next is that Max's gastric emptying is surely delayed. This would add to the Tetracycline issue because it could be sitting in Max's stomach for longer periods of time than it would for most people. In addition, the delayed emptying causes his stomach to become enlarged and that causes irritation, leading to the hiccups/rumination. Also, along with the delayed emptying and larger stomach, there could be and probably is pain there, but not pain that Max would necessarily feel. And pain in the gut can cause the diaphragm to contract. Now add the fact that Max has grown about 2+ inches since May. He is obviously eating more to fuel that extremely accelerated growth. The extra amounts of food put into an already overstressed stomach makes for more trouble. The there is that " stress " word. That can also cause irritation. We all know that Max is an anxious kid and can easily become overwhelmed. Stress causes more acid in the gut and more irritation. What do we do? Apparently there is a breathing method that can be used to control the rumination. But the GI did not know how to do it. Another GI specializes in this, but he was unable to locate him. Great. We also have to address the delayed emptying. Max is supposed to eat small, more frequent meals. (Hello - I've been telling him that for weeks now!!!) He cannot have any soda or anything that could irritate his stomach or add extra air in there. The GI is considering trying erythromycin to speed the emptying, but he is not sure of how it would interact with the other meds he takes. That will be checked out tomorrow with the psychiatrist when Max sees her. He also wants to do an endoscopy next week if the hiccups continue over the weekend. He can check to see if there are any ulcers and, if necessary, restretch the opening of the pylorus. It is possible that there is scar tissue from the pyloraplasty Max had 2 years ago. That would narrow the opening. The psychiatrist - she is going to begin to change Max's meds around to address the stress issue. He's due for a change anyway. Previously he took Zoloft and had great success with it, but he had to stop it when he took Cisapride. Now that the med is not being made anymore, he can go back on Zoloft and possibly Risperdal again. So, we have some explanations, no cure, and a wait and see answer. The only good news is that the hiccups/rumination are not continuous right now. They are still coming on, but he gets some breaks inbetween. I'm exhausted both physically and emotionally. I just need a good cry. Jodi Z Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 23, 2005 Report Share Posted September 23, 2005 Jodi, Hang in there...We all feel your pain. Take some time for yourself this weekend. How about leave Max with his dad and spend some quality time with Jenna? Now that things are better with her, that might be nice for both of you. How about a nice manicure etc together. Get some rest, Judith, Steve, (RSS) and (non RSS) 5 1/2 year old twins Quote Link to comment Share on other sites More sharing options...
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