Tuesday, October 7, 2008

AJ's appointment

It ACTUALLY went well.  GASP!

I get there, wait forever in the waiting room... as always... the nurse takes me back to the exam room and says "Micaela will be here soon."  I say, "Micaela???  I thought he was seeing Neil? [nurse practitioner]."  She says, "No, Neil is out again today."  Mommy has a moment of panic hear, thinking if it is Crazy-Doctor I will walk out right this minute.  I ask, "Which one is Micaela?"  She describes her to me and I know that is not the crazy doctor.  In fact she did Elijah's last well baby exam and she was a total sweetheart who has a child a little older than Eli.  I told the nurse that is fine, as long as I don't see crazy doctor I'm okay.  She asked me which doctor I meant - I describe her, she laughs and says no you don't have to see her.

So Micaela (who is the Physicians Assistant I found out) comes in and says, "So the formula isn't helping?"  I explain to her we've tried everything, we've tried AR, then we just tried Nutramigen over the weekend.  If can't see ANY difference with Nutramigen.  In fact, he's spitting up more again ON IT!  She says, "Well Dr. Valencia is pretty convinced it is reflux.  And something definitely isn't right, it is either reflux or a milk protein allergy."  We discuss again things we've tried, and she says she will order an Upper GI.

As she was walking out to get the referral, she says, "Don't worry, you are doing everything right!"  I said, "WELL GOOD!  On Friday when I came in..." -- you all know the story -- I explained to her EXACTLY what crazy-doctor said to me.  Of course I couldn't keep myself together and started crying when I retold what happened.  She gets this look of HORROR on her face, pats me on the shoulder and says, "Oh no!  I'm so sorry!!!  She should have NEVER said that to you!  You are doing everything right!  I'm so sorry hun!!"  Grand total, she apologized to me 3 times throughout the rest of the appointment.

After she steps out I hear her talking to Dr. Valencia about Adam.  They decided to make sure they agreed on what to do and treatment plan.  Micaela explained to me she really wanted Dr. Valencia's input so I would have a second opinion and know we are doing everything the right way, and WE are ALL in agreement.   She says, "Lets keep him on Enfamil AR.  That seems to have had the best luck, so forget Nutramigen, don't worry about soy or anything like that, just let him go on AR and Dr. Valencia and I agreed to prescribe a low dose of Rantidine right now because it seems so much like reflux, at least until we get the Upper GI done and find out where to go from there."  She explains rantidine should help with his whole inside system... indegestion, heartburn, gas, everything... at least the low dose should help take the edge off... and she says because there's no reason he should suffer!  (THANKYOUVERYMUCH!!)

She ordered the upper GI stat, so when I called for an appointment, said she ordered it stat, they made room for him to go in tomorrow morning at 9:30, and he goes back for a follow up next Tuesday.

After Micaela apologized, yet again, she said poor Adam has gone through this long enough we really need to be taking further steps now -- i.e. upper GI, medicine, etc.  Depending how the upper GI comes back will determine where we go with medicine, dosage, etc, and if he should continue to stay on AR, or move over to Alimentum (apparently that is the gentlest formula out there, so she says!)

I'm so relieved to FINALLY be getting somewhere! 

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