Tag Archives: exhaustion

“Elementa(l)ry, my dear Watson”

(with profuse apologies to all Holmes fans out there, but I just couldn’t resist!)

As we head into our 5th month of E028, the positive impact of the elemental diet on M is plain to see.  Family, friends and even casual acquaintances have commented on his improved health, behaviour, appearance and overall much happier demeanour.  We have seen glimpses of the happy-go-lucky, confident and outgoing child he can be when constant pain is not plaguing him and we have celebrated that success with him.  We’ve even embraced the somewhat daunting prospect of food trials despite the lack of useful advice we were originally given and have ploughed on regardless, surviving the highs and lows of this latest rollercoaster ride. Believe me, there have been plenty of both.

The highs have been encouraging; 

highsWe have successfully reintroduced rice, chicken and cucumber to his diet and he’s loving being able to eat something solid once again.  I’ve adapted, tweaked and sometimes created from scratch recipes to give him a range of meals that make meal-times more exciting than just plain boiled rice, grilled chicken and a few slices of cucumber 3 times a day.  We’ve even found a new favourite in rice noodles, something he would never eat when he was small and, thanks to the advice of 1 kind reader, I have even managed to lay my hands on a bag of the elusive rice pasta and he’s enjoying the variety to his diet.  The bonus of finding some amazing allergy-friendly restaurants earlier this month was a real boost and will make a big difference to us all.

M has stayed positive and has very much been involved in making the decisions about what foods he trials next.  We are working closely with our GOSH dietitian to choose our hit-list of foods in a balanced manner and I speak to her every 2 or 3 weeks to provide an update on our progress.  Even better, she is constantly contactable via e-mail, which has given me huge peace of mind as I know I can ask her any questions I might have and she will always come back to me by either phone or email, even if it’s just to say she’s looking into it and will let me know.  We’re once more on a small break, but are looking forward to attempting carrot, corn and apple over the coming few weeks.

And the lows have been exhausting.

exhaustionmanageI never realised just how exhausting the process of food challenges would be and that’s on all levels: physical, mental and emotional.  Each new food starts with the excitement and hope that it will be a safe food for M and managing expectations has become key.  It feels easy at the moment to be downhearted as we have had 4 fails – pineapple, pork, sweet potato and banana – and a question-mark over the 5th – salmon; but it’s critical we stay positive as there are an awful lot more foods for M to try, and every success brings with it many more options for meals.  Unfortunately, every fail leads to disappointment and discouragement and we have to pick ourselves up, brush ourselves off and look forward to the next one as best we can.

The need to be constantly alert to the risks of cross-contamination during food prep, as well as ever-vigilant about rogue additions to lists of ingredients and being constantly alert to any signs of a reaction in M, requires a stamina I didn’t know I had.  That is something I’m sometimes finding it hard to hang on to.  Whilst we are almost desperate to successfully introduce another ingredient to our meagre list, it’s become clear that we have to do it at a pace that suits M’s pernickety digestive system, and that seems to be a very slow rate indeed.

SHERLOCK_HOLMES_-_01-743978However, despite the exhaustion and the blood, sweat and tears shed in the name of finding another safe food, the future is looking bright and M’s better health gives us all a reason to keep going, even when it seems tough.  To have him in the best health we’ve known for 9 years means that our decision to go elemental really was…well…”elementary, my dear Watson.”

The First Hurdle

Our GOSH admission had three key stages, the first of which was to dis-impact M’s bowel and prepare him for a repeat pellet study.  We knew that when the original transit study was done at our local hospital 18 months ago, he was chronically impacted and there was some debate over whether the results, that suggested his transit was relatively normal, were accurate or not. My honest opinion was that he was not struggling with a slow transit colon, but the gastro team at GOSH wanted to be certain and were more than happy to admit him for this test due to the issues we’ve experienced with our unsympathetic local hospital over the last 12 months. My instinct was that nearly 9 years of unrelenting diarrhoea meant that there had to be another root cause for his problems that was still waiting to be discovered and it would just take some persistent looking to find it.

Courtesy of ebsta.com

Courtesy of ebsta.com

Unfortunately, the first hurdle – after the resolution of the whole missing bed saga – proved to be far tougher than any of us had anticipated.  After his amazing courage in facing all the health and medical challenges of the past year, and despite knowing that he needed to have a NG-tube, M showed just how stubborn he can be and steadfastly refused to co-operate with the nurses who were trying to pass the tube.  Wednesday evening saw 5 different nurses, 4 attempts, a flurry of unsuccessful negotiations and 1 small boy, who pulled the last 2 attempts out himself because, according to him, the nurses weren’t listening when he asked them to stop and then told them to go.  Having kept the other occupants of the 4-bed bay awake until past midnight with his cries and screams, we all finally admitted defeat and decided to leave it to the next day’s nursing team to remedy the situation.

Thursday morning arrived far too quickly, with a disturbed night’s sleep for M and an uncomfortable one for me.  We talked about the tube and the need to have it in place as soon as possible so that we could start on the first round of treatment, the dreaded Klean prep – a highly effective laxative that would start the process of clearing his system.  M knew and accepted all the reasons for the tube, but at the heart of the matter was the fact I had a small, scared 8 year old, who had endured a great deal since his scopes last October and was evidently close to saturation point.

Courtesy of The Royal Ballet/ROH Johan Persson

Courtesy of The Royal Ballet/ROH Johan Persson

Even the lure of tickets to go to see “Alice in Wonderland” performed by the Royal Ballet at the Royal Opera House, Covent Garden that very afternoon looked unlikely to be sufficient draw, but my boy’s love for all things theatrical combined with my own enthusiasm for going to see anything at the Royal Opera House eventually overcame his worst fears and won the day.  He agreed to let one of the doctors pass the tube and with 4 of us holding his head, arms and legs, another distracting him whilst it happened and the doctor doing the deed itself, we finally got the tube in place.  With that hurdle tackled, M and I rushed to get ourselves ready and a bag packed for our trip to the theatre.  We went by taxi with another little girl from the ward and a nurse and arrived just in time to take our complimentary seats in a box before the ballet began.  The performance was an amazing visual feast and proved to be a more than adequate distraction from all the tears and trauma of the morning.  M loved the outlandish costumes of the Mad Hatter and we had a lot of fun trying to work out which of Alice’s family and friends were depicted by each of the fantastic characters we met throughout the rest of the ballet.

Courtesy of The Royal Ballet/ROH

Courtesy of The Royal Ballet/ROH

Naturally, as I’ve come to expect when dealing with anything to do with M, nothing was as straight-forward as we might have hoped as we headed into that all important first full day of admission.  The stress of the tube placement led to him being violently sick within 10 minutes and he spent the rest of the day retching and bringing up bile, meaning the Klean prep couldn’t be started until much later in the day.  He reacted to the Duoderm, a dressing usually used to protect the fragile skin of the face by forming a barrier between the cheek and the tube and tape, which meant there was no alternative but to tape the NG-tube directly to his face.  The final straw came in the middle of the night, when after I’d finally got my tired chap to sleep, the quantity of the Klean prep being pumped in at the speed it was upset his system and he woke to be sick for the second time in less than 24 hours.

By the time Friday morning came around, we were both feeling emotionally fragile and physically exhausted and M refused point-blank to move from his bed.  We sat quietly on ward, with M plugged into the television via his headphones and I immersed myself in the escapism of a good book.  It had been a bumpy start, but finally we were on our way.