Doctors Lounge - Pediatrics Answers
Forum Name: Pediatric Topics
Question: possible pyloric stenosis
|helpingfriend - Sun Aug 14, 2005 9:01 am|
I am one frustrated friend. My friend's infant 3.5 month old baby girl has been in the hospital twice due to "malnutrition", low birth weight. Last weight 8/11/05, she was 7 pounds 6 oz. At first they figured it was young parents..no common sense. However I've watched this baby on several occasions and not only did she look like a skeleton, but after feeding she would vomit her entire bottle. They have tried different formulas, thinking food allergy and changed her to soy and even today she has vomited it up. I asked her doc about pyloric stenosis and the are going to do an ultrasound Monday, but they don't seem to think it's anything like that. I don't understand why it's so difficult for have this checked out or what makes them think it couldn't be this. To me, it makes perfect sense.
|Michele P, RN - Sun Aug 14, 2005 11:55 am|
The baby could possibly have GERD. As for your question to why they havent ruled out pyloric stenosis yet, there could be many things that did not suggest that this is what it is. Some might be:
1. It is more common in male infants
2. It is common to run in families
3. more common in caucasians
4. most have type B or O blood
5. Normally develops around 3weeks old
6. baby is constipated
7. mucus in stools
8. most times there is a "mass" (lump) that feels like a pit that can be felt in the belly
Diagnosing pyloric stenosis requires some tests at times that could be difficult for an infant - if the ultrasound does not show an enlargement or thickening, they might have to do other tests such as a barium swallow. That would require getting the baby to drink a liquid that is not so tasty then take xraysof the stomach to see if there is any narrowing or obstruction. If they were to find that, hospitalization & surgery would be required.
Its a process of elimination to tell you the truth with diagnosis & based on what symptoms are being exhibited, that is where they are going to lead diagnosis wise.
If the parents do not feel comfortable with the care they are receiving for the baby, I would suggest a 2nd opinion. Based on what you said with switching formulas, hospitalization for monitoring, etc., it seems they are taking the normal steps in ruling out different possible reasons for the intolerance.
Best of luck :)
|helpingfriend - Tue Aug 30, 2005 12:53 am|
MissNurseM: I just wanted to let you know the status of my friends baby. The ended up finding by ultrasound, that she did in fact have pyloric stenosis and immediately operated on her. It has been nearly 2 weeks since the surgery and baby is doing so much better. I immediately saw a change in her appearance...her face was fuller and her eyes didn't look sick and lethargic anymore, and when I fed her the other day, she drank a full 4 ounces with no problems... I am relieved that she is on the mend, but a bit frustrated with the nonchalent attitude of the doctors that were treating her. It wasn't until they sent her to a different hospital with different doctors that the did the ultrasound. I am not a doctor, but if I can do research on my own and come up with possible diagnosis, can't the doctors? They let that baby sit in a hospital for 1 full week...actually 2 weeks before they took the test seriously..with no IV nourishment, steadily loosing weight. By the time they operated, she was 6 pounds...a nearly 4month old baby girl....6 POUNDS!!! I know it must be very difficult for the medical community to have normal every day people have a better diagnosis them they. I don't want the "I told you so credit" or a pat on the back....I just want open communication between doctors and patients (or their friends) and for each other to be taken seriously. That baby could have died if she were to go on much longer.
|Michele P, RN - Tue Aug 30, 2005 3:17 pm|
I'm so happy that they finally got to a diagnosis & she is starting to feel better.
I understand your fustration & I do agree, it seems that sometimes you want to say "Duh...Doc..what don't you get???" But sometimes it IS hard to make a diagnosis. Also, not to get political or cause a whole other can of worms to spill here, but unfortunetely sometimes health insurance companies have a lot to do w/the treatment of patients. I've seen more people - INCLUDING MYSELF - have to wait longer to get to a diagnosis or treatment than they should have to in my opinion but what can you do when there are restraints that health care professionals have?
A very fast story - now mind you - I work w/these doctors & this happenned to me - I was left sitting in a hospital, much like the baby - in pain, etc. for over 2wks. I had an ongoing issue that I felt was gallbladder related. Went to the ER 1 night when I couldnt take it anymore....was admitted right away based on my statements, not on tests. Because I'm known by the staff, they automatically said my statements match gallbladder, thats what it is, get her settled in, we will test in A.M. The morning came & I had my catscan which didnt show any evidence of it being a gallbladder issue. Hidascan, ultrasound, barrium swallow, endoscopy, gyn referals, you name it...it was not my gallbladder according to tests. Finally, on the 12th day, my doctor came to me & said :"We believe you but don't know what it is & insurance is not going to pay for all these tests, you know this. We have done all the tests & more that we didnt even need to, they simply will not pay". It didnt matter to me - I demanded I have the operation anyways & so even though I read my chart (which said in doctor's notes that they are aware that they might be doing this for nothing), I proceeded w/surgery. When I awoke in the Recovery room, my surgeon said they all were so wrong. Just because the tests didnt show it, didnt mean there wasnt an issue. My gallbladder was rotten. A *Good* gallbladder is normally a robbin's egg blue color - mine was green & other unpleasant colors.
My point here is that they allowed me to sit there in misery & even tried to send me home & I WORK THERE. I'm 1 of them but there was only so much from an insurance point that they are able to do. don't take this as a healthcare professional will allow a person to die if insurance wont cover it, but so long as there is no immediate risk, sometimes it happens.
The only other comment I can make is that maybe you did unfortunetely go thru a case of incompetence. In that scenerio, it is sad to say, but being aware of your own health, your child's, etc. is important & if you don't feel that you are not receiving care that you should receive, you must be the one to take the 1st step to go seek another opinion.
In spite of all the politics, the what if you had changed doctors sooner, who found the diagnosis.....the point is the baby is ok & thats what is important.
Take Care & Best of Luck :)
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