Wednesday, April 30, 2014

April Clinical trial visit

A little information: Luke is getting continuous feeds about 20 hours a day. I was sure that once he started getting continuous feeds that he would really start gaining weight. When he was getting the bolus feeds in his stomach he usually threw up one or two of those a day. All those wasted calories were now staying in and I figured it would allow him to grow. Well I was wrong. After several trials with different calorie concentrations we were right back where we started....40 calories per ounce and just maintaining his weight. I talked to Dr. D (Clinical trial Dr) about him not gaining weight. She talked to Dr. A (Gastrointestinal Clinical Trial Dr) and they decided we would have a special meeting when we came on Thursday.

Normal kids his age need 850 calories per day to GAIN weight. Luke is getting around 1100 every day and just maintaining his weight. Any less and he loses weight. We can't change his formula concentration anymore because he is maxed out and don't want to overload his kidneys. Plus one thing I didn't think about that Dr. D said was when we start weaning his formula and Luke has to start eating....All he is going to have time for is to eat. If he has to eat 1100 calories a day then he won't have time for anything else.

I scoured through the boxes of papers we have for Luke and tried to find any test that we have had done on Luke and took them to the clinical trial appointment. We sat down and talked about him, past symptoms and current. Dr. A was very thorough. We talked and decided to run a bunch of labs and get a belly x-ray. We will be doing growth hormone studies, pancreatic studies, blood count, electrolyte labs, kidney and liver function test, and allergy tests. Some of this stuff has already been done but it has been around 2 years so a lot can change in 2 years. He started him on a new reflux medication. There is talk of doing a "scope" on him again-which is a video camera looking at the insides of his digestive system but that is only if nothing else is found. There are some other options available but again they are future things. I will wait to discuss them until we decide to do them.

So for the time being we are "on hold" with the clinical trial. They liked to say "deviating from protocol." Again I struggle with "I hope they find something wrong vs I don't want anything to be wrong." Finding a diagnosis would give us something to treat but then that mean he has something and no mom wants their child to have a disease or syndrome or disorder.

The trip was great. Weather was good on the way up and decent on the way home. We had some rain on the way back but nothing hard and not more than 20 or 30 minutes. On the way up to Kansas City we stopped and saw my last primary from work. I loved getting to see her mom and snuggle with her. She has gotten so big and chubby (which is good for preemies)! We ate at our favorite Italian restaurant and Luke enjoyed a plate of cannoli cream. In the morning we went back to our favorite restaurant and Luke drank some coffee creamer. creamer. He wanted to try it so I let him. Calories are calories!

Will keep updated as we find out results from the study. As of right now we still have our next appointment on May 15th.

Clinical Trial Week 3

Week 3:
Very good drive up to Kansas City. We have gotten our stops pretty much figured out. Going up we stop maybe twice...bathroom break, a snack, and to feed Ally. We have found a place that sells local pecans and other goodies. Our favorite so far has been their cheddar horseradish Amish cheese. Ally is really good on the ride up and doesn't fuss much unless she is hungry.

We get into Kansas around 2 or 3 and eat a late lunch. Usually we pick something big so we can take leftovers to the hotel for dinner and of course a dessert. This week we found a GREAT place. It is a little Italian restaurant called Cupini's Italian Food. It was one that I found online while scrolling through Google Map. It is a deli style Italian restaurant and WONDERFUL.The lady working the counter was very nice and gave us the whole run down of the menu. Mom got their lasagna and I got chicken pasta with a pink sauce. Mine was okay but mom's was the winner of those two. When we go back I will get something with their marinara sauce because it was yummy. We had also gotten delicious stuffed zucchini and an order of garlic bread. They had some beautiful desserts. We got a passion fruit/raspberry cheese cake and a tiramisu to go for later. We also split a cannoli. I had Luke try a bite of the inside cream and he LOVED it. It has cinnamon in it and was delicious. He finished almost all of the inside of our cannoli and was asking for more. The wonderful lady at the counter knew we were in Kansas for a clinical trial for Luke and his feeding tube. We asked if we could have a little bit more of the inside cream for Luke and she squeezed us a good amount into a cup...and didn't even charge us! He ate some more and we took the rest with us back to the hotel, We will go back there again...maybe even in April...even if just for dessert! We went to the hotel, unpacked, and then went swimming in the hotel's indoor pool. This is Luke's favorite part!

Mom and I had talked about how we were getting tired of the hotels breakfast. There isn't much for me to eat as I can't eat eggs (Ally doesn't do well when I eat them) and their orange juice is watered down and the pancake machine was broken the week before. We went to a breakfast place and it was very good too. Luke ate a couple bites of pancake and they had some lemon curd that he inhaled.

It has become apparent that Luke gets a little anxious about his appointments as he always says "I don't think they will need to poke me today or lay me down" We are honest with him and tell him that they will need to but like always it is very fast and doesn't hurt very much and he can get a treat afterwards. One morning he was acting out and I told him that if he didn't start acting right he was going to lose privileges. He looked at me and asked "I will lose my feeding doctor privileges? I won't have to go?" I couldn't help but smile...poor (smart) guy was trying to lose privileges so he didn't have to go to the doctor.

God has been very good to us on our travel days. Twice it was forecasted to be bad weather on our return days and both times we have been fortunate enough not to run into any rain. We have encountered strong winds but no severe weather! The trip home seems to take longer and we have to stop more often for Ally...she isn't too happy the last couple hours. We have found a lunch stop that has 2 play indoor playground at a Burger King and an outdoor playground at a Sonic. Luke enjoys running around and playing while mom and I eat lunch.

The next couple weeks we aren't doing much....continuous feeds and medicine. Have to talk to Luke's nutritionist at Children's Hospital to see if we can tweak his formula recipe and try to get him to gain weight. He hasn't gained anything yet but has gotten a little taller. We need him to pack on some pounds because they are expecting him to lose 10% of his body weight when we start weaning his formula and he doesn't have much to lose right now. Please pray that we can get him to gain weight quickly! I would love for him to his 30 pounds before we start weaning formula and losing weight.

Luke snuggling with Ally before bed
Grandma Barnes gift was light up balls. This is a screenshot of the boys skype-ing before bed and showing each other with toys.

Our next travel visit is April 23.

Tuesday, April 1, 2014

Clinical Trial Week One and Two

Luke and his backpack
Week One: We started with our appointment on Monday March 10th. We left early and drove up to Kansas City on Sunday. We had a fabulous (late) lunch at the Cheesecake Factory and then hung out at the hotel as we were too tired to do anything else! Monday morning we packed up, went to his appointment, and then drove home to Arkansas. The appointment went well. They weighed him, measured his height, did another EKG, and more blood work. Those things we will have to do every visit. This visit we got "the medication" - we don't know whether it is the Amitriptyline or the placebo. The nutritionist had figured out 2 different feed options for Luke's continuous feeds. He has to get 26 ounces in a day over a minimum of 10 hours. One option was a rate of 75 mls/hour over 10 hours and the second option a rate of 65 mls/hour over 12 hours. I laughed at that because he has NEVER gone over 45 mls/hour without having stomach pain, gagging, and throwing up. Even though the formula bypasses his stomach, the formula going too fast makes him uncomfortable and end up throwing up whatever is in his stomach. There was hardly a night when we were doing continuous feeds that he didn't wake up between 12-3 screaming and crying because his belly hurt. They told us we would slow it down to whatever rate he was comfortable long as we got the 26 ounces in. The first day we tried out his feeding rate at 65 mls/hr but he didn't tolerate it. We bumped it back to 45 and he did better. After a couple days we started increasing it and he currently is running at 57 mls/hr! He is tolerating it and sleeping through the night!

Luke's favorite part of the appointment was when they gave us a lunch bag with an ice pack to keep his medicine cold. He wasn't excited about the bright cool lunch bag but the ice pack! We were leaving the appointment and walking through the lobby. Luke would stop, look at someone, hold up the lunch box, and it a loud whisper say "ice pack." He would then move on to the next person without a second glance to that person. Mom and I were cracking up at him! The older people in the lobby thought he was pretty cute too.

Ken's mom has been sending little gifts for the boys to open on travel days. Week one gift was Star Wars action figures. My mom has been getting Luke and Jack little things too. This first visit was the light up light-sabers. This visit was spider man sunglasses for her car. The boys are loving the attention.

Week 2: We are slowly ramping up his medication dose. We haven't seen much change except for tolerating the continuous feeds at 57 mls/hr and some loose stool! He is doing a little better about trying new things...but only if he initiates it. Same things at the appointment: blood work, EKG, weight, and height check. He lost a little weight but only a little bit so no big deal. The big event this trip was Luke's feeding tube came out during the night. He woke up around 3am complaining that his sheets were wet. I thought maybe his pull-up leaked but as soon as I turned the light on I saw his tube laying in the bed. I don't know how long it was out but I had a hard time getting it back in. Because I had such a hard time getting the tube back in his stomach, I was afraid to feed him until we got it evaluated. We were in Kansas City and headed home that day. We didn't make it back into Little Rock in time to get his tube replaced at Arkansas Children's Hospital. We had to wait until the next morning to get it replaced.

This week's present from Ken's mom were storm trooper pez dispensers. Luke has never had pez before and he ate a whole pack in one sitting. Mom got him new shoes and got Jack some Russell Stover candy. Anyone who knows our children know that those were the perfect gifts to meet their personalities.

Luke showing the nurses and doctors his pez dispenser after his appointment