kimberly June 18th, 2010
As of Monday afternoon, we now have a date for Leah’s g-tube surgery: October 12.
Last Friday we met with various people at SickKids’ g-tube clinic: two nurse practitioners, a dietitian and a physician. What we thought was going to be an easy, one-hour appointment stretched to well over three hours by the time we learned about the surgery (and actually got to see what the g-tube looks like), went over Leah’s daily intake and got some other food ideas to try and finally chatted with the doctor about next steps.
On a good day, Leah probably consumes only 70% of her daily calorie requirements. On a good day. A less than stellar day likely only nets Leah about half of her needed calories. That’s kind of scary, and so while she has grown a little taller over the past couple of months, she hasn’t gained a single gram. Eek.
All of Leah’s tests and scans came back completely normal, so what we’re left with is a happy, energetic little girl who just doesn’t eat. Because there appears to be nothing anatomically wrong that is preventing her from eating, the doctor recommended waiting till October for the surgery so that we could work on behavioural causes over the next several months and possibly make enough progress so as to warrant the g-tube unnecessary.
To that end, we’re meeting with a child and youth psychoanalyst on Monday, who can hopefully provide some assistance from a behavioural perspective. In addition to just a general lack of interest in food, Leah has also developed the gross habit of chewing food (that she usually enjoys) and then spitting it out in little piles around the house. Ugh. I remain optimistic that the psychoanalyst can help though I remain realistic about the likelihood of surgery.
The dietitian we met with was great and offered us several food suggestions that we’ve been trying with Leah (unfortunately, most ideas haven’t been met with much enthusiasm on her part). Todd and I have already been adding 35% whipping cream to her cups of whole milk, but we were advised to be making greater use of spreads and dips, like cream cheese and ranch dip on vegetables and agave nectar drizzled on apple slices. Guess what? Leah scrapes off the cream cheese and eats just the cucumber rounds and flings the extra-sweet fruit off her plate. It was also suggested that I add chocolate chips to her trail mix, but she eats the raisins, dried apple pieces and pecans and leaves behind all the bits of chocolate. Or worse, picks them out and dumps them on the floor. Sigh.
Today I gave her some pretzels to munch on and when she seemed to be losing interest, I tried to model “eating the yummy pretzel.” Leah took a tiny nibble and then poked the remainder into her bellybutton. If I didn’t know better, I’d think she was mocking me.
Tags: dietitian, g-tube, leah, psychoanalyst
