{"id":3696,"date":"2010-07-28T19:39:39","date_gmt":"2010-07-29T01:39:39","guid":{"rendered":"https:\/\/www.thepickyapple.com\/blog\/?p=3696"},"modified":"2010-07-28T19:39:39","modified_gmt":"2010-07-29T01:39:39","slug":"gi-update-decision-time","status":"publish","type":"post","link":"https:\/\/www.thepickyapple.com\/blog\/2010\/07\/28\/gi-update-decision-time\/","title":{"rendered":"GI Update: Decision Time"},"content":{"rendered":"<p>We met with The Littlest Apple&#8217;s GI specialist again this week.<\/p>\n<p>At 35 months old, The Littlest Apple is 24 pounds, 34&#8243; tall.\u00c2\u00a0 He&#8217;s still not on the charts yet for weight (despite what the pediatrician told us incorrectly last week), but making progress especially given <a href=\"https:\/\/www.thepickyapple.com\/blog\/2010\/06\/21\/gi-update-clogged-tube-and-tape-removal\/\">all of the hurdles we&#8217;ve faced with the NG tube<\/a>.<\/p>\n<p>The doctor wants to increase The Littlest Apple&#8217;s night feeds just a little, and we&#8217;re keeping him on the same formula, despite the increase in energy (which seems to just be from the calorie increase).\u00c2\u00a0 His energy level has to max out <em>eventually<\/em>, right?\u00c2\u00a0 I&#8217;m hoping we&#8217;ve reached that point, because, wow,<a href=\"https:\/\/www.thepickyapple.com\/blog\/2010\/07\/23\/six-tiring-tidbits\/\"> some days really wear me out<\/a>.<\/p>\n<p>The doctor asked us whether we wanted to switch to a <a href=\"http:\/\/kidshealth.org\/parent\/system\/surgery\/g_tube.html\">G-tube<\/a>.\u00c2\u00a0 Now that we know this method of feeding works, we have that option.\u00c2\u00a0 The doctor can&#8217;t tell us with certainty how much longer we&#8217;ll be using tube feeds, but it will be <em>at least<\/em> another 3 months.\u00c2\u00a0 Once The Littlest Apple reaches the desired weight\/BMI, he&#8217;ll need to prove that he can eat enough orally to sustain his weight before we are completely done with the tube.\u00c2\u00a0 It could take 6 months.\u00c2\u00a0 It could take a year.\u00c2\u00a0 It could take much longer, if his <a href=\"https:\/\/www.thepickyapple.com\/blog\/2009\/11\/09\/gastroparesis-always-feeling-like-you-just-ate-thanksgiving-dinner\/\">gastroparesis<\/a> continues to be a problem.\u00c2\u00a0 So it is completely up to us whether we want to make a switch, and we plan to make a decision in the next week.\u00c2\u00a0 If we&#8217;re going to switch to a G-tube, we&#8217;d like to get it done before The Littlest Apple starts preschool in September.<\/p>\n<p>Here are some factors we&#8217;re weighing&#8230;<\/p>\n<p>Reasons to use G-tube:<\/p>\n<ul>\n<li>Better for long term use.\u00c2\u00a0 No tape constantly irritating face.\u00c2\u00a0 Can be used for several months or longer before it needs to be replaced.<\/li>\n<li>More &#8220;hidden&#8221;&#8230;you wouldn&#8217;t be able to tell he even had a tube with his shirt on.\u00c2\u00a0 Right now we get LOTS of attention (and staring) and lots of questions when we&#8217;re out in public.\u00c2\u00a0 The first appearance wouldn&#8217;t be that he is &#8220;sick&#8221; or &#8220;different.&#8221;<\/li>\n<li>Less likely to be pulled out (mostly a concern with other children, particularly the under 3 crowd who are very curious).<\/li>\n<li>No more monthly tube and tape changes (such misery for all involved!)<\/li>\n<li>NG tube irritates the nose<\/li>\n<li>NG tube in throat is an addition eating\/swallowing hurdle.\u00c2\u00a0 I&#8217;ve noticed The Littlest Apple (who has a strong gag reflex) gagging more frequently w\/ the NG tube.<\/li>\n<\/ul>\n<p>Reasons to keep using NG tube:<\/p>\n<ul>\n<li>Surgery needed to place the G-tube and the pain associated with recovery from surgery (a couple days in the hospital)<\/li>\n<li>We&#8217;ve FINALLY gotten comfortable using NG tube<\/li>\n<li> will our insurance (who won&#8217;t cover the formula b\/c it isn&#8217;t his &#8220;sole source of nutrition&#8221;) even cover G-tube surgery?\u00c2\u00a0 Would it be considered elective surgery?\u00c2\u00a0 How much would THAT cost?<\/li>\n<li>A little bit bigger deal to replace g-tube (though Dr. said many parents are comfortable doing this on their own)<\/li>\n<li>Unsure how The Littlest Apple would handle an extra &#8220;button&#8221; on his tummy.\u00c2\u00a0 Would he pick\/pull at it or be protective of it?<\/li>\n<\/ul>\n<p>This is SUCH a hard decision to make, especially not knowing how much longer we&#8217;ll need it.\u00c2\u00a0 If we could say with certainty we would only need tube feeds for another 3 months, I&#8217;d stick with the NG tube.\u00c2\u00a0 If we knew for sure it would be a year or more, I&#8217;d definitely want to switch to G-tube.\u00c2\u00a0 Anything in between is a gray area for me, but I&#8217;m leaning strongly toward making the switch.<\/p>\n<p><strong><em>What would YOU do?\u00c2\u00a0 I&#8217;d love to hear some opinions!<\/em><\/strong><\/p>\n<div class=\"linkwithin_hook\" id=\"https:\/\/www.thepickyapple.com\/blog\/2010\/07\/28\/gi-update-decision-time\/\"><\/div>","protected":false},"excerpt":{"rendered":"<p>We met with The Littlest Apple&#8217;s GI specialist again this week. At 35 months old, The Littlest Apple is 24 pounds, 34&#8243; tall.\u00c2\u00a0 He&#8217;s still not on the charts yet for weight (despite what the pediatrician told us incorrectly last week), but making progress especially given all of the hurdles we&#8217;ve faced with the NG [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[71,67,49],"tags":[],"class_list":["post-3696","post","type-post","status-publish","format-standard","hentry","category-gastroparesis","category-medical","category-motherhood"],"_links":{"self":[{"href":"https:\/\/www.thepickyapple.com\/blog\/wp-json\/wp\/v2\/posts\/3696","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.thepickyapple.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.thepickyapple.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.thepickyapple.com\/blog\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.thepickyapple.com\/blog\/wp-json\/wp\/v2\/comments?post=3696"}],"version-history":[{"count":9,"href":"https:\/\/www.thepickyapple.com\/blog\/wp-json\/wp\/v2\/posts\/3696\/revisions"}],"predecessor-version":[{"id":3705,"href":"https:\/\/www.thepickyapple.com\/blog\/wp-json\/wp\/v2\/posts\/3696\/revisions\/3705"}],"wp:attachment":[{"href":"https:\/\/www.thepickyapple.com\/blog\/wp-json\/wp\/v2\/media?parent=3696"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.thepickyapple.com\/blog\/wp-json\/wp\/v2\/categories?post=3696"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.thepickyapple.com\/blog\/wp-json\/wp\/v2\/tags?post=3696"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}