Tuesday, October 12, 2010

Ian's first follow-up visit with the Gastroenterologist

Ian had his follow-up visit with his Gastroenterologist, Dr. Narahari, this morning. He got there early and they were able to see him early. The doc is very straight forward and Ian's a little overwhelmed. The doctor phoned me while Ian was still in the exam room to discuss things with me, too.

Dr. N's office will call an allergist to refer him so that the two offices will coordinate diagnosis and treatment. Once we discover the food that is causing the allergic reaction, and the inflammation in the esophagus goes away, Ian's dosage of Prilosec will drop back to a normal daily dose for the rest of his life.
Until then, Ian must still continue a "soft-food" diet. In other words, no meat! Foods that are not soft, like meat, would risk another obstruction and could cause the esophagus to tear.

The normal opening of the esophagus is greater than 18 (units;) Ian’s is currently at about 10 (units.) So, Dr. N wants to perform a series of Esophageal Dilations. Dr. N explained that this has to be done slowly so as to not stress the inflamed esophagus and cause it to tear, so he can expand the esophagus, at most, 3 (units) in each procedure. We’re looking at at least two, maybe three procedures. (i.e., the first one will take him to ~13 (units) and the second one will get him to ~16 (units)… hopefully the allergist find the offending food and Ian will remove it from his diet and the rest of the inflammation will recede to normal esophagus diameter.) Each procedure should last no longer than 30 minutes. If all goes as planned and Ian eliminates the offending food from his diet, he will be able to avoid a steroid swallow that asthmatics take. As said before, the Prilosec will continue but at normal doses.

Next problem: Dr. N has access to the Endoscopy suite on Wednesdays. Dr. N would have liked to start the first procedure tomorrow or next Wednesday. Ian has classes and labs all day on Wednesdays. Ian needs to see if he can do his lab on a different day and talk to his professors about missing lectures. If Ian is unable to work things out, his first open Wednesday is the day before Thanksgiving (no classes that day.) He also needs someone to drive him on days he has the procedure(s) because he’ll be under general anesthesia for the procedures.

So, that’s where we are as of right now.

Eosinophilic Esophagitis

(originally written as an email to family members on Tuesday, October 5, 2010)
...what a mouthful.

Evidently, my son has it.

He called around lunchtime on Sunday, telling me he had taken a bite of lunch and it went down real hard. When he took a sip of tea to help it down, nothing went down. His throat filled up and he ended up spitting it all out (except for the piece of food still stuck in his throat.) He couldn't swallow anything else down and he couldn't cough the food up, so he was on his way to the Urgent Care or the ER. He'd call me back. Luckily, he was still breathing and talking normally. A fraternity brother was with him, driving him.

Next call was from a PA at the ER. They couldn't do anything for him so they were sending him to the Operating room. The Gastroenterologist on call would be there within an hour. We asked Ian if he wanted us to come; he knew we'd want to see him so he didn't tell us not to come.

We hopped in the car for the 3-hour trip to Raleigh and got the call from his Gastro... Ian is a healthy young guy so he didn't expect any problems with the Endoscopy or general anesthesia. He expected the procedure to last about 30 minutes and he'd call us when he was done.

Still en route, the procedure finished and the doc called us back. As expected, the procedure was successful. The doc pulled a couple of bits of pork barbecue from Ian's throat and was able to gently push the rest down into his stomach. However, he noticed signs of Ian having a condition called Eosinophilic Esophagitis; basically, an allergy to something that presents itself in the throat. The gastro took some samples for biopsy.

Gastro doc wants to see Ian back in a week. He'll also need to start with an allergist to find out what it is he's allergic to.

Since Douglas lives in Raleigh, we tried calling and texting him. A little later, when he finally called us back, we found out he was in Raleigh this day (he travels a lot,) so we were able to send him over to the hospital. He was able to check Ian out before we even got to Raleigh.

Liquid diet on Sunday; no driving for 24 hours; soft diet starting on Monday for an entire week. Yesterday morning he texted me and said, "I'm kind of hungry." LOL! Poor kid.

We took him to get his prescribed meds; Prilosec, 40 mg, twice a day. The insurance company denied the Rx because the dosage was more than they would allow. So we just bought boxes of the OTC stuff to supplement what insurance "would" allow. Sheesh!
Later that night, after we took him to the library to study, and picked up his car from where he left it, we took him to the grocery store to buy him soft foods for the week. He'll still be hungry, I'm sure. Yesterday he said he had some sores in his mouth and his neck was sore. I told him he probably had sores in his throat too and that's why he's on soft foods for the week. He understands all this and I'm sure he'll comply.

And he's already called the Gastro and set up his follow-up. What a good kid!!! I love that boy!!! I went online to a local Raleigh forum and found some recommendations for an allergist, so I sent him that info this morning. The kid's such a hypochondriac that I'm sure he's elated that he now has a verified reason to see an allergist. LOL! I expect to hear that he's made that appointment, too!

Anyway, he's doing alright now. Just need to find out what he's allergic to (probably milk. and who knows what else.) And he'll need to either avoid the food or live with the prilosec and a steroid that asthmatics use. Once we see what the culprit is, then we'll decide on the way to deal with it.

trying out a new app on my EVO 4G

Just a quick post to try out a new app I downloaded to my phone. BTW, this EVO phone is pretty darned awesome! A couple of the installed apps could use some upgrades, but it's really simple to find other apps that will do what I want.
The phone takes pretty decent pictures, too, if you can steady your hands while taking them. ;-)
Ian got the same phone. The other day, we both signed into the pre-installed app called Qik. With it, we can video chat. When we tried it, we were just sitting across the table, but I can see how it could be beneficial in the next few months.
Speaking of, I think I've found something to journal.
Well, here's my first post from my EVO. Probably not my last.
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