This morning we went to our 2nd appointment with the GI specialist, who Ross and I refer to as Tomato (not out of affection). Her name is Dr. Tomaino, and when our pediatrician first told us about her, we thought he said Dr. Tomato (it sounds just like it!). Anyway, we are NOT fans of her... not at all. She is young, and typically I would think this was great, thinking that she would be up to date on the most effective treatments and practices. She was probably in late middle school or early high school when our pediatrician was doing his residency. What she apparently lacks in experience she overcompensates for with her attitude, and a defensiveness that the social worker in me screams is from her lack of confidence. From comments she has made, I assume (yes I could be wrong) that she has no children. Not that this is a deal-breaker, but when you are going to be dismissive, patronizing, and condescending, you'd better have something to back it up with.
Tomato came in and asked us how we were, and we replied, "not great." She said, "why not??" We said, "well, our son doesn't eat, doesn't sleep well, and screams all the time, like we said last time." She said, "of course he eats, he's growing well!" I said, "he WAS growing well, but not anymore." Newborns are supposed to gain at LEAST an ounce a day... when they are this tiny, they are supposed to grow/put on weight like crazy, because they grown an insane amount in the first year. From the day we returned from the hospital, Asher has gained an ounce or more a day, every day, as evidenced by his weekly weigh-ins at his appointments. Well, he had his 6 week pediatrician appointment on 10/31, and he weighed 12lb 9oz. Today, eight days later, he weighed 12lb 8oz (when he should be well over 13lb by now). Tomato shrugged it off saying, "he's FINE, he's in the 90th percentile!" This isn't true, he's in the 80th percentile now, and I reminded her that he CAME OUT that big... he started off in the high 90s, and now is in the 80s... and just because he started off as a big baby or is "big" for his age doesn't mean that he is OK, and doesn't mean it's fine for him to lose weight. She then attributed it to the fact that her scale might be "way off" from our pediatrician's scale... now, these are scales used only for medical offices, they are probably fairly accurate, and also, Asher was already weighed at her office once, and that time (a few weeks ago) he showed weight gain from the pediatrician's previous weight. Whatever, she's an idiot. I have more colorful names for her, but Ross says that I can't post them.
Tomato then proceeded to dismiss everything we said (I said a ton), and scold us for not listening to her. She said that we and our pediatrician (mind you, they are colleagues through the same hospital) "un-did" everything she told us to do, so basically it was our fault Asher was like this. We explained to her that we kept him on the stupid medicine for 13 of the 14 days she recommended (we previously thought we took him off at day 12, but it was actually only a day early). We reminded her that the medicine did NOTHING to help, and asked her flat-out if it was going to magically work in those last 24 hours. She stuck to the fact that "it can take up to 2 weeks to be effective." AHHHHHH! SOOOOOO frustrating.
She then went on to scold us for not taking Asher to see an occupational therapist as she had recommended, to help with Asher's feeding aversion. We told her that our pediatrician suggested we hold off on that, stating that until we figure out what is causing the pain and "get a handle on it", working with a therapist would not likely help the aversion, as the pain that's causing the aversion will still be there. He said, "it doesn't take too many times of touching a hot stove to realize it's going to burn you... once you learn that, no matter what you do, you are not going to want to touch it again until it won't hurt anymore." We totally agreed, thinking as long as Asher is having pain when eating, a therapist isn't going to be able to solve his aversion to eating... we need to first solve the pain issue! Tomato was mad at us about that and continued in her condescending attitude.
We, mostly I, fought with her for about an hour, reiterating forcefully ALL of Asher's symptoms, onset, etc., trying to make her listen. We asked if there was anything we could do to help the reflux or to confirm that it was the only thing causing a problem. She smarted off saying that she told us what to do already and we didn't listen... even though we told her we tried her crap, and it didn't work. We requested an upper GI series, but she flat out refused to scope him. An upper endoscopy would prove exactly what's happening inside him, as there would be a camera in there to see what the problem is. She basically said that he had to be dying (puking blood, bloody diarrhea, and excessive weight loss) before she would consider it.... In a patronizing manor she offered to do an upper GI scan (he drinks a barium solution and they x-ray upper GI), and then said she didn't think he needed it and didn't think it would help. We told her we wanted it... I don't have much faith in it, as it's only really useful to rule things out. It's used to tell if there are any anatomical abnormalities (hernia, twisted intestine, pyloric stenosis, etc.), which I doubt there are, but it's not that invasive and will at least rule out some stuff for us. Tomato went on in her condescending tone, saying that "some babies just cry" and "he probably just has a case of colic", going on to tell us why he probably has colic. I fought her on every point. First of all, we think a diagnosis of colic is crap. I mean, I know that kids that get that diagnosis have serious issues and it's hell for their parents, but we are both convinced that doctors say "colic" when they can't put their finger on what is wrong and why babies scream their guts out. I argued with her that he screams ALLLLLLLL day, every day; colic is almost always only during a specific time of day. I argued with her that his screaming is only surrounding feeding (before, during, and sometimes after), and he was happy during other times. She dismissed everything, and gave us some stupid article about colic. UGH.
We reiterated that we FORCE him to eat and that every feeding takes about 90 minutes (it should take 20 tops for a bottle fed baby), as we have to do this dance with him to calm him to the point of almost being passed out, and then force him to eat while 1/2 asleep. It was like she didn't hear us at all. She suggested foolish things as if we were idiots, things that we have tried a million times over the past few weeks, and things that don't work. She wasn't helpful at all, really. At our demand she finally ordered the upper GI scan. We are waiting for radiology at the hospital to get the order from her so they can call us to make the appointment. She told us to see the occupational therapist to "help" with the feeding aversion. I don't think it would be helpful at this point until we know and can control the pain, but we are going to do it next week, just for the purpose of telling Tomato we did it, and it didn't help. She suggested mixing a small amount of rice cereal in Asher's bottles to thicken the formula, since we told her that the only thing that has helped him in the past was a thicker formula for reflux. We then told her that he can't handle the rice and it constipates him horribly, and she suggested that we still do it and try prune juice for the constipation (which we already did LAST time, and it didn't help). We are going to try bottles with rice cereal for a couple of days like she said, but even if the thickening helps the reflux, I doubt he will be able to tolerate the rice for long, as evidenced by his last reaction to it. We left feeling angry and frustrated... I spoke my mind and fought back countering everything she said, but basically she is kind of useless to us. She is good for ordering tests that we want, but other than that, doesn't seem to be of much help at all. So, we will get the upper GI scan and see the OT, but I'm not holding my breath regarding either. Stupid Tomato. I desperately WISH it were "colic"... if it were, he would only cry at ONE time during the day, not at every feeding, every day. If it were colic, it shouldn't cause him to have an eating aversion, that might not go away now until he is school-aged... if it were colic, he would be at his peak this next week, and grow out of it a few weeks after. If only...
Gaaaaa! Tomato.
ReplyDelete