Very depressed

arielsmom · #1 10-20-2003, 11:01 PM

I am sooo upset. Ariel had her G-tube and Fundoplication surgery a little more than a month ago and tonight after her evening bolus (over about an hour and a half) she got really aggitated and vomited a good amount. She shouldn't be able to vomit!!!! A few weaks ago after a paricularly vigorous PT session on her stomach she vomited about a teaspoonful after a good deal of coughing and gagging. I told the GI Doc and he wasn't that worried because it was a small amount. Tonight however it just came right up. We are scheduled to see the surgeon on Wed. for her first Mick-ey change and of course I will let him know, but I feel like the surgery was not succesful or she popped her stitches internally or something. Also she is requiring more 02 which is really getting me down, and of course non of her docs can really tell me anything helpful, I have been begging the pulmonologists for a bronch for weeks, I feel so frustrated like we can never make any forward progress. Has anyone else experienced vomiting with a Nissen?! Sorry this is kind of a ramble, I'm in a bit of a rush!!
Karen

cariaad · #2 10-21-2003, 12:54 AM

Unfortunately we have. Alli's first fundo came undone after 4 months. It may have been sooner than that, but it took that long (plus a life threatening event that ended in a 911 call) to get the doctors to believe it had failed so quickly. I would call the dr asap and let him know that she is able to vomit freely. A barium test may be able to show if it is intact at all. I've also been told that some kids can vomit freely even if the fundo is intact, so it may just be that she is one of those. The O2 may be because of the time of year. Up until this year Alli would go thru a spell of a few days of lower sats each time the weather did an about face. This year she seem to have outgrown that. I hope you find out about the fundo's status and can get things ironed out. Deb

Jacks Mum · #3 10-21-2003, 03:07 AM

Its a little scarey when our babes vomit after a fundo..
Jack has a few spills here and there, not large however..

30% of fundos dont work/come undone, which isnt good enough for us when it means are children can aspirate.

I make sure Jack is fed 3 hourly not 4 or 5, I am determined to make this fundo work.. he is also fed cont. over night..

we lay him down and dont sit him up post feeds, which i am happy to do.

I hope things go well

arielsmom · #4 10-21-2003, 02:48 PM

Thanks guys,
I talked with the nurse specialist today and she is sure that when I see the surgeon tomorrow he will want to get an upper GI. I have a bad feeling the fundo has failed and she continues to have reflux which is contributing to her increased 02.

I also think I was getting overzelous with her feeds trying to get to bolus feeding routine, but before her surgery she would suck down like 200cc in 20 minutes! She's nowhere near that now. Deb thanks for the tip about the wheather, our wheather has been all over the place. (I want to believe!!!) Ariel's 15 months, somebody please tell me it will get easier!
Karen

Stefan & Jennifer · #5 10-21-2003, 03:32 PM

Yup, we just joined the fundo vomit club ourselves last Friday. Jake's had a ton of air in his stomach and has been gagging a lot and last Friday he vomited after one of his feedings (also very slow, 130cc over an hour). We're seeing the new LOCAL (what, no 350 mile drive to see a doctor?) pedi surgeon tomorrow; he'll probably order an upper GI....here we go again. You're not alone in this boat, I'm afraid.

Hang in there....we're going to try ourselves....

Stefan & Jennifer

arielsmom · #6 10-21-2003, 03:40 PM

Stefan and Jennifer,
Interesting that we are both seeing the pedi-surgeon tomorrow, keep me posted please. Don't you want to just throw something?
Karen

Stefan & Jennifer · #7 10-21-2003, 04:38 PM

Yes, it's frustrating. Jake has major craniofacial surgery coming up on 10-31-03 and the timing on this couldn't be worse. We hope that the Nissen held and his vomiting was a one-time thing.

We're seeing small brown "chunks" in Jake's residuals. It doesn't look like dried blood and we wonder what it could be...might be curdled formula from the antibiotics that he's on right now (he's on Augmentin because he had an abcess on his rectum) That's one of the things we'll be asking the doctor about. We'll keep you posted and hope you do the same....good luck.

Stefan & Jennifer

Stefan & Jennifer · #8 10-22-2003, 03:06 PM

Predictable results after visit with pedi-surgeon today: upper GI scan tomorrow; another day or two of barium poops. He says that IF the nissen needs to be redone he'll try to coordinate it so that it's done in Dallas at the same time as the cranial surgery (we'll see if that's going to fly, we sure hope so, less time in hospital overall)....I like this doctor, Jake peed all over the exam table while I was changing his diaper (his timing is impeccable, ha ha) right as the doctor walked in and he helped me clean up the mess without batting an eye.

Hopefully the nissen is still intact and this vomiting was a rare event just to keep us on our toes. We've really been vigilant about venting his stomach during and after feeds and he has not vomited again, although he does still gag and get uncomfortable. The quick venting really helps with that though.

Karen, please let me know how things went on your end and I'll post again after we get the results of the upper GI back.

Stefan & Jennifer

christyw · #9 10-22-2003, 03:51 PM

I was told that it absolutely IS possible for the child to vomit, even tho there is a nissen. Gaithy has never really vomitted...but she used to have a lot of trouble gagging because she couldn't tolerate the volume of feeds (this is common), sometimes she would gag and choke so much that she would spit up a small amount of formula. That would totally freak me out, because it was very unusual for her and happened very infrequently....still it wasn't much, just a small amount.

If the vomitting seems to be getting easier coming, then maybe the nissen did come undone. I think that is fairly common, but not our experience.

With the increased O2 - somebody needs to check her out, especially if any fever comes - she could be aspirating this. The docs should listen to you! I hope you are able to get thru soon.

christy Â*

Oh - I just saw your second post. I wish you luck at the doctor's office....and things probably will get easier, but Gaithy was around 2.5 years old before I felt like I could say things were relatively better...it all depends on the child and the medical conditions, but hopefully things will die down soon!!

Wishing Stefan, Jennifer, and Jake the best too!!!!

cariaad · #10 10-22-2003, 06:37 PM

I wanted to add about the volume--don't forget that the stomach is smaller now than before the fundo (they wrap part of it around the esophogus). So not tolerating the same volume is no surprise. Poor Alli's had it done twice which really contributes to her tolerance issues. If it comes undone again, we're not sure she can have another and have enough stomach left! HAve you tried a 24 hour feed at a slow rate, and then work towards an overnight and bolus during the day? Deb