We can't be sure, but all signs point to the fact that we are dealing with Collin's first stomach bug. I'll spare everyone the gory details, but Collin started retching somewhat severely Tuesday afternoon. I thought this was strange after so many good days on the Prevacid, but he was also having lots of dirty diapers, so I assumed the two were related. My first signal that something was wrong was when he woke up out of his sleep retching -- something that has never really happened before. Things got worse and worse and I started to worry about him busting his Nissen, so I called the GI doctor on call at Cincinnati Children's, since we don't have a GI doctor in town and the team up there knows Collin fairly well. I didn't know the doctor I spoke to, but she was very thorough and as helpful as she could be given the circumstances. She felt uncomfortable prescribing anti-nausea medicine given Collin's complicated medical history, but okayed us to give him an extra dose of Prevacid.
Sometime in the middle of the night, after letting Collin empty his stomach, I went on a Pedialyte run and we started concentrating more on hydration. He finally calmed down enough to fall asleep around 6:00 in the morning and seemed to feel much better the rest of the day with nothing in his stomach. We decided to give him a full day with no food to give his tummy time to heal.
This morning, I made a special, easier-to-digest blenderized ketogenic recipe for reintroducing food. Evidently, though, Collin wasn't ready. After only an ounce of food, he started retching worse than ever and carried on for several more hours. I talked to his pediatrician, who recommended withholding food for another few hours then sticking to water and Pedialyte for the rest of the day. When we try to reintroduce food again, we'll do it much more slowly even than this morning.
It's awful to have a child with a stomach bug (we're still assuming that that's what we're dealing with), and our matters are made more complicated by the ever-complex Collin Francis. As I've mentioned before, because of his Nissen, he can't vomit, so we have to help him do it through his feeding tube. Because he can't eat, we have to try to figure out when he's ready for food/water/etc. on our own. Because he's on the ketogenic diet, we can't let him just skip too many meals because his ketones will get too high and send his body into acidosis. But we can't feed him things like juice or soft drinks or even too much pedialyte because his ketones will get too low and he could lose seizure control. We've been checking his blood sugar and ketones every 2-4 hours and adjusting accordingly with water and pedialyte.
Collin, of course, only knows that he feels yucky. Like any other sick 2 year-old, he has spent the past two days in bed watching videos and getting TLC from his parents. As nice as that is, we'll all be glad when this is behind us.