Thursday, April 12, 2012

First Nutrition Consultation

Last month, GI referred us to nutrition because C hasn't been gaining.  Today, we had the long awaited appointment with the nutritionist.  We were eager to explain what we've been trying and to get some new insight and ideas.

Unfortunately, the dietician we are working with has the personality of a rock.  She took FOREVER to get a length on him because he struggled and panicked.  She didn't even try to calm him down while he screamed she just pulled harder trying to get him to straighten his legs. She didn't react to any of my attempts at humor nor listened when I tried to tell her details I thought were both relevant and important.  This is our first experience with someone who didn't want to know or care what he'd been through.  She treated me like he and I were irrelevant to the caloric formula she was working with.

I tried to tell her about the number of times he's been sick over the winter, which is when the failure to thrive recurred.  She said anything that occurred before was irrelevant.  Refused to listen to me when I tried to tell her he was sick this week and ignored the fact that the month he wasn't sick he gained 12 ounces.  She wouldn't even entertain the idea of listening to me explain what has happened as far as his illnesses and eating over the last 6 months.

Here's the main thing I wanted her to hear: from 2/29 - 3/30 we recorded a 340 gram weight gain.  But from 3/14 - 4/12 we recorded a 30 gram weight gain.  He was getting over RSV on 2/29 and was healthy from 2/29 all the way through 3/30.  However, he wasn't healthy for the 3/14 - 4/12 time period, specifically 4/6-4/12.

Last Friday (4/6) He spiked a fever of 103.9, it was at first thought to be an ear infection, so they prescribed Augmentin (which messes with his eating).  On Saturday night he screamed all night long and wouldn't nurse or drink anything beyond a few sips of water, his throat was VERY sore.  We took him back to the doctor on Sunday (after hours clinic) and they diagnosed a virus causing stomatitis in the form of sores covering the back of his throat.  His ears were clear then.  He didn't eat that day, but finally started nursing again Sunday afternoon.   On Tuesday I called my PCP and she agreed we could stop the Augmentin because it was probably the fever that caused his ears to be red.   He ate the bare minimum for the last 6 days (mostly goldfish crackers and water) which I think explains the weight issue we're seeing at this weigh in.  He's continued to have a fever off and on throughout the week.  Wednesday and tonight (Thursday) he's had a fever around 102-103 degrees.  He completely refused to eat lunch or dinner today.  He had a biscuit (no butter) for breakfast, 13 goldfish for lunch, crackers with cream cheese for snack and the daycare convinced him to drink some heavy whipping cream.

This week is only a sample.  The entire winter was like this!  She wouldn't let me talk about that.  She told me I had to get him to drink 20 ounces of fortified whole milk a day (either pediasure, boost or carnation instant breakfast) in addition to .  I tried to explain he hates that stuff and would rather not drink.  She said no water, fortified milk only and to just keep trying until he takes it.  He shudders and whips his head away when he tastes it.  He's begging me for water.  This can't be the right answer.  She wouldn't listen to any of my concerns.  She just kept talking about whipping cream, half and half and butter.

He doesn't like sweet or rich foods generally, he prefers savory foods and veggies.  I was hoping for ideas on how to transition him to being able to eat richer foods.  She just kept saying to only offer those foods.  She wouldn't listen when I tried to tell her he quit eating the last time we tried to "strong arm" him into eating what we wanted.  She wouldn't even really listen as I tried to talk to her about our past eating struggles.  She did tell me that I needed to not express anxiety about him eating because the fact that I'm worried about his calorie count may prevent him from eating.

She refused to look at his recorded food diary.  She said it was too much detail and she just wanted to know what he ate yesterday.  I was trying to show her the difference between healthy eating and sick eating.  She wouldn't even look at it.  I found the whole experience anxiety inducing and not helpful.  We went on a whirlwind shopping trip after we were done and picked up butter, cream cheese, heavy whipping cream and crackers.   He has a new supply at home and day care.

If her goal was to stress me out she succeeded.

1 comment:

  1. What an awful experience. Can you see someone else?