I talked to the GI doctor today. Because of Andrew's age and recent changes:
very thick constant huge amounts of puke - fussiness, doesn't want to eat more than 4 ounces even when very hungry, fussy and choking with every feeding, screaming when spits up and stops eating, general feeding difficulty, tired, pulling on ears but no ear infection
 they said they need to perform an
endoscopy.  He's never had a problem with choking (except when he first came home) especially, and he
keeps doing it.  They don't want to keep writing it off as "could be
teething"...also we've tried increasing the Prilosec with no impact.
(He's already on a higher dosage than term babies typically are.) 
They said the endoscopy is the most comprehensive GI test.  They
can check for a bacteria problem in his tummy (corrected by
antibiotics), allergies (to gluten, or others), any anatomical
abnormalities or narrowings, intestines, and take tissue samples.  They
basically look around with a little camera.
I don't know if they will still perform the swallow study on
Wednesday but I'm concerned about performing both tests on back-to-back
days.  I think he'll be a bit of a wreck, but it may be something we
just need to do.
We're
bummed that he has to go through this test - but we talked about doing
it 3 months ago but when things got better it wasn't necessary....but
things have been fairly steadily worse for a few weeks.  It's a
difficult decision since it could be something normal (teething, a
cold) or something not that needs to be discovered.
The good news is it may eliminate some of the trial-an-error
approaches with medicine.  I hate doing that.  Hopefully we'll be able
to narrow down what's wrong!  Very hopefully we'll get some answers and find that it's just something normal and minor.
 
 
 It's
been a rough few weeks and I'm ready for some answers.  I keep telling
myself this is the right thing to do, and hopefully A will feel better
soon.  My poor baby.
I only have 3 vac days left, so I'm
trying to decide if Ryan and I should both go, or, if I should save my
days (in case he gets sick or something) and let Ryan take him. 
(thoughts?)  Ryan has lots of vac.
Re: Have to do an endoscopy :(
It sounds to me like you have made a decision that is going to be for the best for your son. You'll hopefully get good and thorough information on which the specialists can act, eliminate the lets try this trial and error stuff like you said, and will also have a baseline study for the future in case anythng else comes up down the road. Good job Momma for making the tough call ... the sooner you get the information, the less your son will have to suffer the symptoms he is having now.
I can't tell you what to do about taking off work other than to say you have to go with your gut and decided what you personally need. If you think you will go to work and be preoccupied with worry for your son and won't be productive anyway, then you might want to take the days off for piece of mind. If you feel like your husband can give you the updates and reassurances you need by phone to get through the day at work and stay productive, then it might be good to save the days up as you mentioned - in case you need them down the road once you know what the problem is.
Just trust your instincts and do what feels right at the time ...
I hate to be the one that brings up questions but here it is.
Have they done a swallow study before this one? I would think they would want to do that first and see the results before jumping to the endoscopy. I understand the idea of getting to see a lot of things at once but if the swallow study shows reflux than that kind of answers the question. On the other hand, an endoscopy could give you some good answers and isn't particularly invasive so it's probably not a bad idea.
Have they tried anything stronger than Prilosec like Prevacid?
yes, yes, and yes.
He had a swallow study (as well as an upper and lower GI) done in the NICU. They have a 2nd swallow study scheduled for Wed, but based on his symptoms, they want to do the endoscopy ASAP, so that's scheduled first.
He's been in Prilosec since day 1. (He refused to eat in the hospital until 2 weeks after his due date. THey didn't know why, but finally did a swallow study to discover reflux - and he started eating 2 days after they started Prilosec.)
His dosage of Prilosec has also been increased and he gets 2.0 ml 2x/day..which equates to 1.25 mg per kilo per day which is a good amount. (the "baseline" dosage is 1.0 mg per kilo per day, which he''s historically been on.)
I hope they can help him.
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