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September 29, 2011

Henry's Issues Updates: Acid Reflux

And after three days, we have finally made it to the end of the "issues." But I have saved the most frustrating issue for last. I've mentioned Hen's reflux in a ton of posts, but the main story is here.

So it turns out acid reflux is a bitch to control in babies. It just plain blows. We have pretty much had to deal with reflux continuously since Henry's initial diagnosis and my first post. It seems that as soon as we think we have it under control something changes and we are right back to where we started.

When I last updated, Henry was taking a 1/4 of a teaspoon of Zantac twice a day. This medication/dose actually worked pretty well for a couple of weeks. But there was two problems with Zantac that we quickly learned about. One, Zantac's effectiveness is tied to a person's weight. For an adult that isn't rapidly growing this isn't an issue, but for a baby (who at that time was gaining between a 1/2 pound and a pound every couple weeks) its a huge issue. Second, the longer someone takes Zantac the less effective it is at controlling the heartburn. Essentially, every day Henry was on the medication these two issues were combining and the medication was becoming less and less effective.


Within a couple of weeks of starting Zantac, we started to notice that a lot of the same acid reflux symptoms were starting to come back. Henry was extremely fussy, stopped sleeping well at night, woke up screaming, didn't want to be flat on his back, was coughing and gagging all day/night long, and was fussy while eating. We contacted the doctor who believed it was time to increase the dose of Zantac to try to combat Hen's weight gain. So the dose was increased.

After the increase we noticed a decrease in all the typical acid reflux symptoms, but all of a sudden Hen started spitting up all.the.time. It was a constant stream of barf around here. Which was really unusual. Henry almost never spit up before this. So after more talking with our pediatrician (who was finally back from maternity leave), Morgan and I learned that while high doses of the heartburn medication will take the heartburn away, they actually can make babies quite nauseous. Blah. Hen was spitting up because he felt sick all day long. But he wasn't terribly bothered by the spitting up, so we learned to adjust and kept up with that dose of the medication.


As Hen gained weight, he once again started to outgrow the dose, which stopped the spitting up. But it caused the symptoms to return. By this time (mid-August) it had become pretty clear to us and our doctor that Zantac wasn't working for Henry anymore. It was time to move to a different type of medication altogether. It was time for a PPI (for those our you unfamiliar with heartburn these are proton pump inhibitors and they actually shut off the acid making glands in your stomach, as opposed to just making the acid less painful). So our doctor prescribed 7 ml of Prilosec once a day.

Let me tell you, Henry was once again a one-hundred percent different baby after starting Prilosec. He was sleeping great (for Henry) and was super happy during the day. There was just one problem. Liquid Prilosec happens to be the nastiest, most vile medication on the planet. And, 7 ml is a TON of liquid for a baby. You try getting a baby to eat that night after night. Well, Henry wasn't having it. He would get so upset at the very sight of the syringe that it became impossible to give it to him. He would scream so much that he would end up throwing up any of the Prilosec that he hadn't already spit out. It became a hugely stressful and painful process for Morgan and I. We finally had to stop giving it to him altogether. And honestly, I can't blame Henry for this. Morgan and I both tried the liquid. I gagged after trying a couple drops. So did Morgan. I seriously cannot believe doctors, pharmacists, or drug manufactures actually expect an infant to take this medication.


We were back at the drawing board, and our doctor came up with an alternative. She decided we would give Henry adult Prilosec in his food. So Morgan and I would open a capsule of adult Prilosec take half of the medication out and mix it into Hen's dinner at night. This was actually a decent solution and it took away the reflux symptoms, when we could get Henry to take the medication. I just had some problems with giving Henry medicine this way. One, we had to force him to eat; if he didn't like the food or wasn't feeling like eating, it didn't matter, he had to eat at least the first few bites. Two, it was really hard to know how much medication he was actually getting. You never knew if you actually gave him "half" or how much he spit out, or how much was stuck in his sticky fingers. It was just really inaccurate. Finally, I was worried about increasing the dose this way. What happens when we need to give him more? How in the hell do we separate the tiny little medicine beads? 3/4ths? 5/8ths? Ugh. I didn't even want to worry about that.

After voicing these concerns to our doctor at Hen's 6 month appointment, we all decided it was best to switch Henry's medication once again. This time we switched to Prevacid (another PPI). While Prevacid doesn't taste great, we only have to give Hen 2.5 ml twice a day. So its much less liquid to try to get him to take. It also seems to be a little more tolerable. However, Hen has only been taking it a week so the verdict is still out as to weather it is controlling the acid reflux symptoms. PPI's take several days to start working so we should know soon if we will see the desired results.


OhMGee. That got super long. Hopefully Prevacid is the answer for us and for Henry. Its very hard to know he is in pain and not be able to do much about it. But our doctor has been great in helping us figure out a solution. Henry still sleeps elevated at night, and will continue to get medication for the foreseeable future. Hopefully by the time he is a year old, we can wean him from both. But for now, we will have to watch him closely and change his medication as needed to keep him comfortable, and to keep our sanity.





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