So the Wizard of Oz (our pediatric gastroenterologist) totally redeemed himself yesterday. It was a rough start, though, so we were wondering how this conversation would go. Our appointment time was 11:20 and at 12:40 we were still in the waiting room with a hungry toddler. Thankfully, as any smart mom would, I came prepared for the hungry toddler part!
We told the Wizard of our troubles with getting information from his medial assistant. We also spoke of the waiting times in the waiting room. The office manager was promptly called in and assured us that not only would we not be charged a copay for yesterday's visit, but our insurance company would not be billed either. I didn't even know a doctor could do that. I guess it's considered pro bono work. Regardless, after the discussion of our frustrations and his office staff not measuring up to the reputation of the doctors, we were more than satisfied with the outcome.
Now on to the results. Nugget tested negative for all food allergies. That's awesome. But his labs came back positive for inflammation, and the upper portion of his small intestine was inflamed and irritated which is typically indicative of a food allergy. The Wizard believes that Nugget was born with an allergy to something (most likely dairy...which explains all the formula issues we had) but has outgrown it. Unfortunately, until the inflammation and irritation in his small intestine subsides he will not be asymptomatic even though he's outgrown the allergy. Sounds confusing, huh?!?!
So here's the plan. We've switched Nuggs from Prevacid (there is no evidence of him ever having reflux, but the symptoms of reflux and a food allergy in infants are very similar. Without testing there's no way to know for sure.) to an antihistamine that will help calm the inflammation in his small intestine as well as a combo medication that is another form of antihistamine combined with an appetite stimulant.
His growth trajectory not only did not improve, it actually got a little worse (he's under the 2nd percentile in weight) because he is growing taller but not gaining weight. Everyone is hopeful that these two medications for a short period of time will right the ship. We have six weeks to put a pound and a half on the little man.
So, how are we going to do that, you ask? That's the fun part! We've been asked to turn Nugget into his Papa. Per the Wizard's orders, "put peanut butter on everything. Anything that you can imagine would be good with peanut butter, spread it on, including spoons. And don't use the healthy, grind-your-own, all natural, Boulder-esque peanut butter. I want you using Jiff or Skippy or another brand with added fat and oil." Ummm...OK!
Here's why. You make 19% of your brain cells after birth. In order to make lots of them (according to the Wizard, this can equate to up to 9 IQ points), you need fat and protein as an infant and toddler. Especially the fat. Lots and lots of fat! And because there isn't much irreparable harm caused with food this early in life, its' best to load kids up on fat from sources like avocados, peanuts, almonds, and olive oil. BTW, for you naysayers out there, in April of this year, the AMA and the American Association of Pediatrics released new guidelines with regard to peanuts and children. And the new ruling is to feed your kids peanut butter much earlier in that it greatly decreases the likelihood of a peanut allergy.
Maybe we should rename Nugget to Skippy! Nah. We like Nugget. Here's hoping that in six weeks we have a chunky Nugget!