Tuesday afternoon was Noah's appointment with Dr. M., a pediatric GI doctor. I had hoped that when we walked out of his office, that we would have orders to stop the monitor and that we would have answers. I was disappointed because we received neither. I am a fan of Dr. M. and I do feel that he has Noah's best interest in mind. He told me that the plan was to get the doctor who did the ph study to correlate the results with the sleep study, both done on December 22nd of last year. I then told him that our pediatrician has been trying to get that done since the study and the doctor refused because Noah wasn't technically her patient. This didn't sit well with Dr. M. and he said this has been a problem for a while and these doctors only do part of the test. He stated over and over that it is very important that the results are correlated to see if the apnea episodes are related to reflux directly or if they are central, related to the sleep center in his brain. He said it is tedious and takes a long time, but that is the whole point of the test to begin with. Dr. M. also stated that when he drops the ph probe in patients and sends them for a sleep study, he correlates the information. This has me wondering why he was not the doctor to do it in the first place, since he has been Noah's doctor since he was a couple of months old. He said we might have to redo the test if they both simply refuse to finish their job, but that would be crazy because the data is already there. Dr. M. told me that the plan of care as of right now is to continue with the monitor until told otherwise and continue with the increased medications. The plan of care for the future is pending on the results of the testing done in December. During the 22 hour study, Noah had 146 episodes of reflux! Keep in mind that this test was done with him being off of his medicine for 5 days prior. Dr. M. said that over 8% of the time Noah is refluxing. He said that one occurrence lasted over 8 minutes. This occurrence, of course, did not obstruct his airway. I would think that based on the ph test results, it's safe to assume that his apnea is related to reflux. The doctor will not assume anything though (which I am happy about, completely). He said that if he has any central apnea, then he will need another medical work up to see what is going on with the 'sleep center' in his brain. Central apnea is related to SIDS and the brain doesn't start or maintain the breathing process. This form of apnea is usually seen in preemies (which Noah wasn't) and usually has a neurological cause, so I am believing that this isn't the case. Dr. M. explained that the plan of care might include fundoplication surgery if it is related to reflux alone. This is where they wrap the stomach around the esophagus and sew it into place. This tightens the valve between the esophagus and the stomach. Dr. M. also stated, which I remember very clearly that 90% of general reflux cases improve on their own by the time the child is two!! So we definitely have hope that Noah will not have this for very much longer! His daddy suffers from reflux daily and I do not want that for my son. I want him to be healed of this, and I would like to throw the monitor in the fireplace, honestly!! So there is my update, and i'm sure there will be more to come. We are disappointed, but I know there will be an update in the future where I can write that all of this worry and waiting is over and he is healed!!
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